Sutureless vascular anastomosis connection

ABSTRACT

Techniques for sutureless vascular anastomosis are described, including an incision seal including a base configured to partially house an outer surface of a main vessel, the base being formed using a material that is configured to be penetrated by a barb disposed on a connector the main vessel being secured to the base when the base is at least partially pierced by the barb, an upper lumen configured to guide a graft vessel, and a housing opening configured to receive the graft vessel.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.12/944,614 filed Nov. 11, 2010 entitled “SUTURELESS VASCULAR ANASTOMOSISCONNECTION,” related to co-pending U.S. patent application Ser. No.12/946,703 filed Nov. 15, 2010 entitled “SUTURELESS VASCULAR ANASTOMOSISCONNECTION,” which is a continuation of U.S. patent application Ser. No.12/944,614, related to co-pending U.S. patent application Ser. No.12/981,406 filed Dec. 29, 2010 entitled “SUTURELESS VASCULAR ANASTOMOSISCONNECTION,” which is a continuation of U.S. patent application Ser. No.12/944,614, related to co-pending U.S. patent application Ser. No.12/982,891 filed Dec. 31, 2010 entitled “SUTURELESS VASCULAR ANASTOMOSISCONNECTION,” which is a continuation of U.S. patent application Ser. No.12/944,614, and related to Co-pending U.S. patent application Ser. No.12/983,037 filed Dec. 31, 2010 entitled “SUTURELESS VASCULAR ANASTOMOSISCONNECTION,” which is a continuation of U.S. patent application Ser. No.12/944,614, all of which are herein incorporated by reference for allpurposes.

FIELD OF THE INVENTION

The present invention relates generally to anastomosis, and morespecifically, to techniques for sutureless vascular anastomosis.

BACKGROUND OF THE INVENTION

Generally, anastomosis refers to the connection of blood vessels orother structures that may be found in the human body. Conventionalsolutions for vascular anastomosis typically refer to the use of devicesand surgical procedures in which one vessel is surgically joined toanother vessel. This procedure is required for a variety of medicalprocedures, including procedures involving redirection of bodily fluidssuch as blood within the patient. One conventional example is a cranialbypass procedure that diverts a portion of the flow of a temporal arterylocated outside of a skull to one or more arteries within the skull inorder to provide additional blood flow to a patient's brain.

When performing any form of vascular anastomosis, a major concern isthat the flow of bodily fluid must be interrupted for the duration ofthe procedure. This interruption of flow, if too long, causesdetrimental effects to organs and surrounding tissue, which canendanger, jeopardize, or worsen a patient's general health.

Currently, a common conventional method of vascular anastomosis includesmanually applying a number of sutures to create a fluid-impermeable sealbetween two vessels. This process is not only difficult, time consuming,and expensive, but also requires a high degree of surgical skill and aconsiderable amount of time and patience from a surgeon. Additionally,the use of sutures introduces a potential weakness in a surgicalconnection placed to connect two or more vessels, often resulting intearing or leakage. Further, a surgeon is often required to test aconventional anastomosis connection between two vessels to ensure thatthe sutures have created a fluid impermeable seal. A leak resulting frompoor or weakened sutures can create a number of problems such asinternal hemorrhaging for the patient, requiring additional surgeries,time, and expense. Also problematic are conventional connectors used inanastomosis procedures that are often bulky, unwieldy, or difficult touse, typically requiring significant skill and specialized equipmentthat can be expensive to manufacture and purchase. Further, the timerequired for submission, review, and governmental approval ofapplications for the use of elaborate medical devices in humans foranastomosis applications is substantial, incurring significant socialand health care costs due to the delay. Some conventional solutions usedin applications such as side-to-end vascular anastomosis often requiremore time, expertise, and effort since joining an end of a vessel to aside of another vessel is more time-consuming and skill-intensive thanjoining an end of a vessel to an end of another vessel.

Thus, a solution for more vascular anastomosis without the limitationsof conventional techniques is desired.

BRIEF DESCRIPTION OF THE DRAWINGS

Various examples are disclosed in the following detailed description andthe accompanying drawings:

FIG. 1 illustrates an exemplary sutureless vascular anastomosisconnector system;

FIG. 2 illustrates a front view of an exemplary sutureless vascularanastomosis connector;

FIG. 3 illustrates a side view of an exemplary sutureless vascularanastomosis connector;

FIG. 4 illustrates a flat pattern of an exemplary sutureless vascularanastomosis connector;

FIG. 5 illustrates a front view of an exemplary sutureless vascularanastomosis connector;

FIG. 6 illustrates a side view of an exemplary sutureless vascularanastomosis connector;

FIG. 7 illustrates a top view of an exemplary sutureless vascularanastomosis connector;

FIG. 8 illustrates a front view of an exemplary incision seal;

FIG. 9 illustrates a back view of an exemplary incision seal;

FIG. 10 illustrates a side view of an exemplary incision seal;

FIG. 11 illustrates a perspective view of an exemplary incision seal;

FIG. 12 illustrates an exemplary incision seal receiving a graft vessel;

FIG. 13 illustrates an end of a graft vessel receiving a suturelessvascular anastomosis connector;

FIG. 14 illustrates a side and cross-sectional view of loading anexemplary sutureless vascular anastomosis connector into an exemplaryintroducer;

FIG. 15 illustrates another side and cross-sectional view of loading anexemplary sutureless vascular anastomosis connector into an exemplaryintroducer;

FIG. 16 illustrates a further side and cross-sectional view of exemplarysutureless vascular anastomosis connector loaded into an exemplaryintroducer;

FIG. 17 illustrates a side and cross-sectional view of an exemplaryintroducer entering an incision in a main vessel;

FIG. 18 illustrates a side and cross-sectional view of an exemplaryintroducer disposed within an incision in a main vessel;

FIG. 19 illustrates a side and cross-sectional view of an exemplaryintroducer inserting a connector inside a main vessel;

FIG. 20 illustrates a side and cross-sectional view of an exemplaryintroducer deploying a connector in a main vessel;

FIG. 21 illustrates an exemplary introducer encompassing a graft vessel;

FIG. 22 illustrates an exemplary introducer detaching from a graftvessel;

FIG. 23 illustrates an exemplary barb-setting device;

FIG. 24 illustrates a cross-sectional view of an exemplary barb-settingdevice;

FIG. 25 illustrates an exemplary barb-setting device;

FIG. 26 illustrates a cross-sectional view of an exemplary barb-settingdevice;

FIG. 27 illustrates an exemplary incision seal-setting device;

FIG. 28 illustrates a cross-sectional view of an exemplary incisionseal-setting device;

FIG. 29 illustrates an exemplary incision seal setting device;

FIG. 30 illustrates an exemplary incision seal setting device;

FIG. 31 illustrates an exploded view of an exemplary two-componentsutureless vascular anastomosis connector system;

FIG. 32 illustrates an exploded view of an exemplary three-componentsutureless vascular anastomosis connector system;

FIG. 33 illustrates an exemplary support tube;

FIG. 34 illustrates an exemplary incision seal;

FIG. 35 illustrates a process flow diagram of an exemplary method forperforming sutureless vascular anastomosis;

FIG. 36 illustrates an exemplary introducer; and

FIG. 37 illustrates an exemplary syringe preloaded with a connector.

DETAILED DESCRIPTION

Embodiments or examples of the invention may be implemented in numerousways, including as an apparatus, system, or process. A detaileddescription of one or more examples is provided below along withaccompanying figures. The detailed description is provided in connectionwith such examples, but is not limited to any particular example. Thescope is limited by the claims, but numerous alternatives,modifications, and equivalents are encompassed. Numerous specificdetails are set forth in the following description in order to provide athorough understanding. These details are provided for the purpose ofexample and the descriptions provided may be used for implementationaccording to the claims without some or all of these specific details.For the purpose of clarity, technical material that is known in thetechnical fields related to the examples has not been described indetail to avoid unnecessarily obscuring the description.

Various techniques and devices for sutureless vascular anastomosis aredescribed, including a connector and an incision seal system that may beconfigured and used to join, seal, or otherwise couple a first vessel toa second vessel without the use of sutures. In some examples, the firstvessel and second vessel pair may be a graft vessel and main vesselpair, a donor vessel and recipient vessel pair, or any other pair ofvessels. As used herein, a graft vessel may be referred to as a “donor”vessel, artery, vein, or the like. Also and as used herein, a mainvessel may be referred to as a “recipient” vessel, artery, or the like.These terms may be used interchangeably without limitation. For example,the graft vessel may be a superficial temporal artery (STA) and the mainvessel may be a mid cranial artery (MCA). In other examples, the graftand main vessels may be other arteries, vessels, veins, or vascularstructures and are not limited to any specific types or structures.Exemplary connectors may be configured to couple a graft vessel to amain vessel to provide a lumen (i.e., a channel, passageway, artery,vein, or the like) to transfer fluids (e.g., blood) between a graftvessel and a main vessel. After an exemplary connector has coupled agraft vessel to a main vessel, an exemplary incision seal may be engagedwith the connector to seal the graft vessel to the main vessel. In someexamples, an incision seal may be configured to lock, mate, or otherwiseconnect with a connector. In some examples, the coupling of a connectorwith an incision seal may create a clamping force that secures a portionof an upper wall of the main vessel between the incision seal and theconnector. In other examples, the described systems may be varied indesign, function, structure, or implementation and are not limited tothe techniques described below.

FIG. 1 illustrates an exemplary sutureless vascular anastomosis system.Here, system 100 includes graft vessel 110, main vessel 120, connector130, tines 132, front wing 134, rear wing 136, tines 135 and 137, sidewing 139, barbs 138, and incision seal 140. In some examples, connector130 may be fabricated, manufactured, or otherwise formed using varioustypes of medical-grade material, including stainless steel, plastic,composites of any type, and alloys such as nickel titanium, Nitinol™(e.g., Nickel Titanium Naval Ordnance Laboratory) or super elasticNitinol™. For example, if Nitinol™ is used, it may be formed at variouspressures and temperatures in order to provide for a memory shape wherefront wing 134, rear wing 136, side wing 139, and barbs 138 aredeployed. As another example, super elastic Nitinol™ may be configuredto behave similar to a spring when a restraining force is removed. Inyet other examples, materials may be used such that when formed, a“material memory” is created in a given shape of connector 130. In otherwords, connector 130 may be formed such that when a restraining force isremoved, a given shape is assumed. When placed into a restrained shapeand inserted into main vessel 120, the restraining force may be removedto allow front wing 134 and rear wing 136 to deploy securely and engageinto the tissue of the upper wall of main vessel 120 using tines 135 and137. As another example, alloys may be used to form connector 130 suchthat when placed into a fluid (e.g., blood) stream such as that withinmain vessel 120, the heat of the surrounding fluid may cause memorymaterial used to form connector 130 to change shape (e.g., deploy frontwing 134 and rear wing 136). In other examples, connector 130 may beformed differently and is not limited to the examples described.

Here, connector 130 may be configured to couple graft vessel 110 to mainvessel 120 in a sutureless manner. Once coupled, fluids may pass betweengraft vessel 110 and main vessel 120. As an example, incision seal 140may be coupled to connector 130 to provide a leak-proof seal betweengraft vessel 110 and main vessel 120.

As shown here, connector 130 may include tines 132, front wing 134, andrear wing 136. These portions of connector 130 may be configured tosecurely engage connector 130 with graft vessel 110 and main vessel 120.For example, tines 132 may be configured to securely engage an innersurface of graft vessel 110 while front wing 134 and rear wing 136 maybe configured to securely engage an inner surface of main vessel 120.Tines 132 may prevent the connector from being displaced with respect tothe graft vessel when the connector is coupled to the graft vessel. Insome examples, connector 130 may further include barb 138 for couplingconnector 130 with incision seal 140. Barb 138 may be configured topuncture a portion of a wall of main vessel 120 and lock with incisionseal 140. For example, incision seal 140 may include a slot configuredto lock with barb 138. In another example, incision seal 140 maycomprise of a malleable material configured to receive and lock withbarb 138. For example, the incision seal may be formed of medical gradesilicone. Locking connector 130 with incision seal 140 may secure thejuncture of graft vessel 110 and main vessel 120 between connector 130and incision seal 140. This may allow graft vessel 110 to securelycontact main vessel 120, thus creating a leak-free seal. Over time,graft vessel 110 and main vessel 120 may graft with one another and forman integrated vessel. In some examples, system 100 may replace barb 138and the slot with other fasteners. Other fasteners may include hooks,clamps, screws, cables, and adhesives to name a few. It should beunderstood by those skilled in the art that a “barb” may be replacedwith a first part of a fastener and that a “slot” may be replaced with asecond part of a fastener in this specification. In other examples, theshape and configuration of connector 130, tine 132, front wing 134, rearwing 136, tines 135 and 137, barb 138, and incision seal 140 may beimplemented differently and are not limited to the examples shown anddescribed. For example, the wings, tines, or barbs may vary in number,shape, and placement.

In some examples, one or more portions of connector 130 may include amemory material that causes the one or more portions to change shape. Asused herein, “memory material” may refer to any material that, whenformed, shaped, fabricated, poured, deposited, or otherwise implementedhas a material property that allows for a physical shape under a givenset of conditions (e.g., temperature, pressure, or the like) and assumesa different physical shape when one or more conditions change. Forexample, a memory material may cause a portion of connector 130 toassume one shape when a restraining force is applied and then assumeanother shape when the restraining force is removed. In another example,the memory material may cause the portion to be spring loaded such thatthe portion springs from a first position into a second position when arestraining force is removed. As shown here, front wing 134 may includea memory material that causes front wing 134 to align with an outersurface of the end of connector 130 when a restraining force is applied.This characteristic may allow connector 130 to maintain a cylindricalshape when inserting into main vessel 120. Front wing 134 may alsodeploy or swing away from the end of connector 130 when the restrainingforce is removed. This characteristic may allow front wing 134 to deployand securely engage the inner surface of main vessel 120 after connector130 has been inserted into main vessel 120. In other examples, theabove-described elements may be implemented differently and are notlimited to the examples shown and described.

FIG. 2 illustrates a front view of an exemplary sutureless vascularanastomosis connector. Here, connector 200 includes connector tip 210,connector body 220, tines 222, and connector base 230. In an example,connector tip 210, connector body 220, and connector base 230 may beintegrated with connector 200. For example, these parts of connector 200may form a continuous tubular structure that may be configured to serveas a lumen for fluid transfer between two ends of connector 200. Inanother example, connector tip 210, connector body 220, and connectorbase 230 may be separate structures that are coupled together to formconnector 200.

In some examples, an interior of connector 200 may serve as a lumen forfluid transfer between a graft vessel coupled to one end of connector200 and a main vessel coupled to another end of connector 200. The rateof fluid transfer through connector 200 may depend upon thecross-sectional area of connector 200. In other examples, connector 200may be made of a memory material. The memory material may provideflexibility to connector 200. For example, this flexibility may allowconnector 200 to slightly flex when forces are applied to connector 200.The forces may be an external force applied to an external surface ofconnector 200 or an internal force applied to an internal surface ofconnector 200. Alternatively, the flexibility may provide functionalityto connector 200. For example, the memory material may allow portions ofconnector 200 to change shape or position. The changes in shape orposition may assist in securing a graft vessel to a main vessel.

As shown here, connector base 230 may be disposed at an end of connector200. In some examples, connector base 230 may be configured to securelyengage a main vessel. For example, connector base 230 may be configuredto securely engage a main vessel through an incision in a wall of themain vessel. This may include inserting connector base 230 into the mainvessel and securely engaging connector base 230 with an inner wall ofthe main vessel. Connector base 230 may include front wing 232. In someexamples, front wing 232 may be composed of a memory material thatcauses front wing 232 to change shape or position based upon externalforces. For example, front wing 232 may be configured to besubstantially planar (or aligned) with an outer surface of connector 200when a restraining force is applied to front wing 232. The restrainingforce may be caused by elastic bands, sheaths, wrappers, or otherphysical elements. Alternatively, the restraining force may be caused bythe temperature or chemical attributes of the environment surroundingconnector 200. For example, the temperature of connector 200 may affectthe restraining force or the chemical composition of a fluid coming intocontact with connector 200 may affect the restraining force. In oneapplication, it may be easier to insert connector 200 into the incisionin the wall of the main vessel when front wing 232 is substantiallyplanar with an outer surface of connector 200.

Front wing 232 may also be configured to deploy from connector 200 whenthe restraining force is removed. For example, front wing 232 may beconfigured to swing away from connector base 230 at front wing junction233 when the restraining force is removed. In other examples, front wing232 may be configured swing away from connector base 230 not as ajunction, but by bending one or more sections of front wing 232. Whendeployed, front wing 232 may be configured to engage an inner surface ofan upper wall of the main vessel. Further discussion of this deployedstate is included below in FIG. 5, FIG. 6, and FIG. 7. In otherexamples, connector base 230 may be implemented and configureddifferently and is not limited to the descriptions provided.

In some examples, front wing 232 may include front tine 234. Front tine234 may be configured to securely engage with an inner surface of avessel. For example, front tine 234 may provide the securing means tosecurely engage front wing 232 to an inner surface of an upper wall ofthe main vessel. As shown here, one end of front tine 234 may be coupledto front wing 232 while the other end of front tine 234 remains unfixed.In some examples, front tine 234 may be composed of a memory materialthat causes front tine 234 to change shape or position based uponexternal forces. The memory material may be similar or substantiallysimilar to the memory material described in front wing 232 of FIG. 2.For example, front tine 234 may be configured to be substantially planar(or aligned) with an outer surface of connector 200 when a restrainingforce is applied to front tine 234. In other words, the unfixed end offront tine 234 may be aligned with an outer surface of connector 200.This configuration may be desirable when inserting connector 200 intothe incision in the wall of the main vessel as it prevents the unfixedend of front tine 234 from snagging or catching onto an edge of theincision during insertion.

Alternatively, front tine 234 may be configured to deploy from frontwing 232 when the restraining force is removed. For example, front tine234 may be configured to swing away from front wing 232 at front tinejunction 235 when the restraining force is removed. In another example,front tine 234 may be configured to form a curved shape when therestraining force is removed. When deployed, front wing 232 may beconfigured to securely engage an inner surface of an upper wall of themain vessel. In some examples, front tine 234 and front wing 232 maydeploy simultaneously or in a specific order as determined by theattributes of the memory material used in front tine 234 and front wing232. Further discussion of this deployed state is included below in FIG.5, FIG. 6, and FIG. 7. In other examples, connector tine 234 may beimplemented differently and are not limited to the examples shown anddescribed.

As shown here, connector body 220 may be integrated as part of connector200 and coupled to connector base 230. In some examples, connector body220 may include body tine 222. Body tine 222 may be implementedsimilarly or substantially similar in function and structure to fronttine 234. In some examples, body tine 222 may be configured to securelyengage with an inner surface of a graft vessel. An unfixed end of bodytine 222 may provide a constant force against the inner surface of thegraft vessel that allows connector body 222 to be inserted into thegraft vessel but does not allow connector body 222 to be pulled out ofthe graft vessel. In other examples, connector body 220 may beimplemented differently and are not limited to the examples shown anddescribed.

As shown here, connector tip 210 may be integrated with connector 200and disposed at an end of connector 200. In some examples, connector tip210 may be configured to be inserted into a graft vessel. To assist inthe insertion process, connector tip 210 may be configured to compresswhen a substantially tangential force is applied to connector tip 210.This force may cause the end of connector 200 to shrink, thussimplifying the task of inserting the end of connector 200 into thegraft vessel. In other examples, connector tip 210 may be configured tomaintain in the shape of connector tip 210 when a substantiallytangential force is applied to connector 200. Changes in the shape ofconnector tip 210 may be undesirable as they may result in pinching orotherwise limiting the flow of fluids through connector 200. Here,connector tip 210 comprises a wave-shaped pattern. The wave-shapedpattern is similar to a sinusoidal wave and is configured to provide acompressible end to connector 200. Furthermore, the wave-shaped patternmay retain its shape when substantially tangential forces are applied toconnector body 220. In other examples, the above-described elements maybe implemented differently and are not limited to the examples shown anddescribed.

FIG. 3 illustrates a side view of an exemplary sutureless vascularanastomosis connector. Here, connector 300 includes connector tip 310,connector body 320, body tines 322, connector base 330, barbs 332 and335, barb junction 333, front wing 334, rear wing 336, and side wing337. Connector tip 310, connector body 320, body tines 322, andconnector base 330 may be implemented similarly or substantially similarin function and structure to like-named elements as shown and describedin FIG. 2. As shown here, connector body 320 and connector base 330 mayintersect along diagonal plane 340. In some examples, diagonal plane 340may represent an angle in which connector 300 and an attached graftvessel are coupled with the main vessel. Thus, modifying diagonal plane340 may alter the angle in which the graft vessel is coupled with themain vessel.

Connector base 330 may include barb 332, barb 335, front wing 334, sidewing 337, and rear wing 336. In some examples, barbs 332, barb 335,front wing 334, and rear wing 336 may be configured to couple connectorbase 330 with the main vessel. In other examples, barbs 332 and 335,front wing 334, rear wing 336, and side wing 337 may be composed of amemory material with similar functionality as the memory materialdescribed above in FIG. 1 and FIG. 2. As an example, the memory materialmay cause barb 332, barb 335, front wing 334, or rear wing 336 to changeshape or position based upon external forces.

Barb 332 may be configured to be substantially planar with an outersurface of connector 300 when a restraining force is applied toconnector barb 332. Alternatively, barb 332 may be configured to deployfrom connector 300 when the restraining force is removed. As an example,barb 332 may bend at barb junction 333 when a restraining force isremoved, thus deploying barb 332 from connector base 330. Alternatively,the entire body of barb 332 may bend away from connector base 330. Inother examples, barb 332 may bend at different locations to deploy barb332 from connector base 330. In some examples, barb junction 333 andside wing 337 may bend simultaneously or in a specific order to deploybarb 332 from connector base 330. In other examples, barb 335 may beconfigured to function similar to barb 333.

Front wing 334 and rear wing 336 may be configured to be substantiallyplanar with an outer surface of connector 300 when a restraining forceis applied to front wing 334 and rear wing 336. Alternatively, frontwing 334 and rear wing 336 may be configured to deploy from connector300 when the restraining force is removed. In some examples, front wing334 and rear wing 336 may be implemented similarly or substantiallysimilar in function and structure to front wing 232 as shown anddescribed in FIG. 2. In an example, front wing 334 and rear wing 336 maybe substantially parallel with diagonal plane 340 when deployed. Thismay allow front wing 334 and rear wing 336 to contact the inner surfaceof a main vessel when deployed. Further discussion of this deployedstate is included below in FIG. 5, FIG. 6, and FIG. 7. In otherexamples, the above-described elements may be implemented differentlyand are not limited to the examples shown and described.

FIG. 4 illustrates a flat pattern of an exemplary sutureless vascularanastomosis connector. Here, flat pattern 400 includes connector tip410, connector body 420, tines 421, pattern 422, connector base 430,barbs 431, front wing 432, side wings 435 & 437, and rear wing 436. Insome examples, connector 200 in FIG. 2 or connector 300 in FIG. 3 may beformed by applying flat pattern 400 to a tubular structure. For example,a laser cutting apparatus may apply flat pattern 400 to a tubecomprising memory material to create connector 200 in FIG. 2 orconnector 300 in FIG. 3. As shown here, flat pattern 400 may includeconnector tip 410, connector body 420, and connector base 430. Connectortip 410, in some examples, may be formed to resemble a “wave” such that,when formed in a substantially circular implementation, a wave-shapedmuzzle is formed. In some examples, connector tip 410, connector body420, and connector base 430 may be implemented similarly orsubstantially similar in function and structure to same-named elementsin FIG. 2 and FIG. 3.

Connector body 420 may also include pattern 422. Pattern 422 may be amesh pattern, a wire frame pattern, a plurality of perforations, or anycombination of openings. In some examples, pattern 422 may be configuredto allow connector body 420 to graft with a surface of a vessel. Whengrafted, the connector and the vessel may be securely coupled to oneanother. As shown here, pattern 422 may be a wire frame. When insertedinto a graft vessel, the wire frame may selectively contact the innersurface of the graft vessel. Over time, tissue along the inner surfaceof the graft vessel may attach to the wire frame. This may lead to theintegration of the wire frame as part of the graft vessel.

In other examples, pattern 422 may be configured to control, adjust, ormodify the flexibility of connector body 420. The direction or locationof flex may be controlled, adjusted, or modified depending upon pattern422. In an example, the width and orientation of pattern 422 may controlthe direction, the location, and the amount of flex in connector body420 when external forces are applied to connector body 420. In someexamples, the direction and amount of flex may be configured to preventpinching or other limitations to the flow of fluids through connectorbody 420. In other examples, the amount of flex may be configured torelieve pressure to the wall of the graft vessel. For example, whenexternal forces are applied to the wall of a graft vessel, pressure onthe wall of the graft vessel may result. A connector body that isflexible may slightly bend in the presence of pressure, thereforerelieving and dampening the pressure. This may minimize damage to thewall of the graft vessel. In other examples, the above-describedelements may be implemented differently and are not limited to theexamples shown and described.

FIG. 5 illustrates a front view of an exemplary sutureless vascularanastomosis connector. In some examples, connector 500 may be made of amemory material that allows connector 500 to change shape. Here,connector 500 includes connector tip 501, connector body 502, connectorbase 503, body tines 510, barbs 520, front wing 530, and front tine 535.Connector tip 501, connector body 502, connector base 503, body tines510, barb 520, front wing 530, and front tine 535 may be implementedsimilarly or substantially similar in function and structure tolike-named elements as shown and described in FIG. 2 and FIG. 3. Asshown here, body tines 510, barb 520, front wing 530, and front tine 535may be configured to deploy from connector 500. In some examples, bodytines 510, barb 520, front wing 530, and front tine 535 may deploy whena restraining force is removed.

Body tines 510, when deployed, may have a fixed end attached toconnector body 502 and an unfixed end curving away from connector body502. The radius of curvature of body tines 510 may be predetermined.Alternatively, the unfixed end may bend away from connector body 502 ata junction. In examples where body tines 510 are made of a memorymaterial, the unfixed end may be disposed when a force is applied to theunfixed end. The displacement may cause the radius of curvature of bodytines 510 to change. In some examples, the amount of displacement maydepend upon the shape of body tines 510 or the material memory in bodytines 510. For example, a thinner body tine may be easier to bend than athicker body tine, thus resulting in a larger change in radius ofcurvature when the force is applied. In another example, body tines 510may be configured to not break or crack when force is applied. Whendisposed, the unfixed end may exert an opposing force as the appliedforce. The opposing force may attempt to return body tines 510 to itspredetermined shape. As an example, the opposing force may be in theopposite direction as the applied force. In other examples, the opposingforce may be depend upon the radius of curvature of body tines 510 orthe material memory in body tines 510. For example, the opposing forcemay be directly proportional to the radius of curvature of body tines510. Alternatively, the opposing force may be constant. When the appliedforce is removed from body tines 510, body tines 510 may return itspredetermined radius of curvature and the opposing force may no longerexist.

Connector body 502 may be configured to be inserted into a graft vessel.In some examples, an inner diameter of the graft vessel may be the sameor substantially the same as an outer diameter of connector body 502.When connector body 502 is inserted, rolled, or otherwise disposedalongside the outer surface of the graft vessel, the insertion may causean inner surface of the graft vessel to apply a force on the unfixed endof body tines 510, thus displacing body tines 510. In response, bodytines 510 may exert an opposing force on the inner surface of the graftvessel. Depending on the orientation of body tines 510, the opposingforce may cause the unfixed end of body tines 510 to securely engage theinner surface of the graft vessel, thus preventing connector body 502from moving in a specified direction. For example, body tines 510 may beconfigured to restrict the graft vessel from moving in the oppositedirection as the unfixed end while allowing a graft vessel to move inthe same direction as the unfixed end. In other words, the orientationof body tines 510 may affect the allowable direction of movement betweenconnector 500 and the graft vessel. As shown here, the unfixed end ofbody tine 522 may be pointed towards connector base 503 and thuspreventing the graft vessel from being pulled back after insertion hastaken place. In yet other examples, connector body 502 may contain morebody tines to better control or limit the movement of the graft vesselwith respect to connector 500.

Barb 520, when deployed, may have a fixed end attached to connector base503 and an unfixed end that deploys from connector base 503. In anexample, the unfixed end may be coupled to a deployable side wing(similar to side wing 337 in FIG. 3) and be configured to swing awayfrom the outer surface of connector base 503 at barb junction 521. Thedeployable side wing and barb 520 may together provide a wide variety ofdeployment configurations varying in position and angle for barb 520. Insome examples, the unfixed end may be configured to puncture an upperwall of a main vessel and engage with a slot in an incision seal. Forexample, the unfixed end of barb 520 may be shaped as a half arrow thatis configured to puncture the wall of the main vessel and not be readilyremovable from the wall of the main vessel once punctured. As anotherexample, the unfixed end of barb 520 may include a sharp end and aprotrusion. The sharp end may be configured to puncture the wall of themain vessel while the protrusion may be configured to lock with a slot.When locked with the slot in the incision seal, connector 500 and theincision seal may provide a clamping force to a portion of the wall ofthe main vessel. To disengage the incision seal from connector 500, asurgeon may exert a force on the protrusion to cause barb 520 to unlockwith the slot. As shown here, barb 520 may be angled away from connector520 when in a deployed state. However, it is understood that barb 520may also deploy at different angles. In other examples, theabove-described elements may be implemented differently and are notlimited to the examples shown and described.

FIG. 6 illustrates a side view of an exemplary sutureless vascularanastomosis connector. In some examples, connector 600 may be made of amemory material that allows connector 600 to change shape. Here,connector 600 includes connector tip 601, connector body 602, connectorbase 603, body tines 610, barbs 620, side wing 625, front wing 630,front tine 635, rear wing 640, and rear tine 645. Connector tip 601,connector body 602, connector base 603, body tine 610, and barb 620 maybe implemented similarly or substantially similar in function andstructure to like-named elements as shown and described in FIG. 2, FIG.3, and FIG. 5. As shown here, body tine 610, barb 620, side wing 625,front wing 630, and rear wing 640 may be configured to deploy fromconnector 600. In some examples, body tine 610, barb 620, side wing 625,front wing 630, or rear wing 640 may deploy when a restraining force isremoved.

As shown here, front wing 630 and rear wing 640 may be disposed onopposing sides of connector base 603. In some examples, front wing 630and rear wing 640 may be configured to swing away from connector base603 when deployed. For example, when connector base 603 has beeninserted into a main vessel, front wing 630 and rear wing 640 may swingaway from connector base 603 and engage an inner surface of the mainvessel. In other examples, front wing 630 and rear wing 640 may beconfigured to swing away from connector base 603 until front wing 630and rear wing 640 are substantially parallel with one another. Here,front wing 630 and rear wing 640 may be swing away from connector base630 until they are substantially aligned with plane 650. Plane 650 mayrepresent the intersection between connector body 602 and connector base603. In some examples, plane 650 may divide the connector 600 into twoportions, the first portion remaining inside the main vessel and thesecond portion remaining outside the main vessel.

In some examples, the mechanical motion resulting from front wing 630and rear wing 640 swinging away from connector base 603 may bedifferent. For example, front wing 630 may swing away from connectorbase 603 at front hinge 631. This may allow front wing 630 tosubstantially maintain its shape while changing its position ororientation. Similarly, rear wing 640 may swing away from connector base603 at rear hinge 641. In other examples, the shape or the radius ofcurvature of front wing 630 may change when being deployed. For example,the shape of front wing 630 may change to conform with the inner surfaceof a main vessel when front wing 630 is deployed. Front wing 630 maychange curvature, orientation, or shape in order to remain substantiallyflush with an inner surface of the main vessel. In some examples, rearwing 640 may be implemented similarly or substantially similar infunction and structure to front wing 630.

Front wing 630 may include front tine 635. In some examples, front tine635 may be implemented similarly or substantially similar in functionand structure to body tine 510 in FIG. 5. When deployed, front tine 635may include a fixed end attached to front wing 630 and an unfixed endcurving away from front wing 630. As an example, the unfixed end offront tine 635 may be configured to contact, penetrate, or grasp aninner surface of the main vessel. In other words, front tine 635 may beconfigured to securely engage with the main vessel. In some examples,the curvature, orientation, and shape of front tine 635 may affect theway or manner that front tine 635 securely engages with the main vessel.For example, the unfixed end of front tine 635 may be configured tosecurely engage with the inner surface of the main vessel in aunidirectional manner. As shown here, front tine 635 may be configuredto prevent removing the main vessel away from connector 600. When themain vessel is moved away from connector 600, the unfixed end of fronttine 635 may engage with the inner surface of the main vessel to preventmovement in that direction. In some examples, the engagement may be bypenetrating or grasping the inner surface of the main vessel.Alternatively, front tine 635 may be configured to not engage with theinner surface of the main vessel when the main vessel moves towardsconnector 600. In other words, front tine 635 may be configured to allowthe main vessel to move towards connector 600. In some examples, reartine 645 may be implemented similarly or substantially similar infunction and structure to front tine 635. In other examples, front wing630 and front tine 635 may be configured to operate, as a single unit.

In some examples, front tine 635 and rear tine 645 may be configured tosupport an incision in a wall of the main vessel. Support may includepreventing connector 600 from undesirable movements that may expand,stretch or otherwise enlarge the size of the incision. An enlargedincision may be too large to be sealed by the connector and the incisionseal without the use of sutures. Thus, it may be desirable to limit themovements of connector 600 once connector 600 has been secured to themain vessel. For example, front tine 635 and rear tine 645 may beconfigured to prevent undesirable axial movements from connector 600 bypiercing and grasping onto an inner surface of the main vessel. Inanother example, front tine 635 and rear tine 645 may be configured toprevent undesirable longitudinal movements from connector 600. As shownhere, the unfixed ends of front tine 635 and rear tine 645 may beconfigured to point towards connector 600. In this configuration, fronttine 635 and rear tine 645 may work together to prevent undesirablelongitudinal movements from connector 600. Front tine 635 may securelyengage with an inner surface of the main vessel when connector 600 ismoved longitudinally in the direction of front wing 630. Similarly, reartine 635 may securely engage with an inner surface of the main vesselwhen connector 600 is moved longitudinally in the direction of rear tine645. Thus, the combination of front tine 635 and rear tine 645 mayrestrict connector 600 from longitudinal movements. In some examples,front tine 635 and rear tine 645 may be configured to securely engagethe inner surface of the wall of the main vessel at two points along acenterline of the incision. In other examples, front tine 635 and reartine 645 may be configured to engage in other locations surrounding theincision.

As shown here, barb 620 may be deployed from connector 600. In someexamples, connector 600 may include additional barbs that, inconjunction with barb 620, may be configured to puncture a wall of amain vessel and couple with one or more slots in an incision seal.Additional barbs may assist in stabilizing the coupling of connector 600with the incision seal by limiting the axial movements and lateralmovements of connector 600. These additional barbs may be the samelength or different length as barb 620. Here, connector 600 may includea pair of barbs facing away from each other. The pair of barbs may beconfigured to deploy together and lock with a pair of slots in theincision seal. In some examples, barb 620 may include an end fixed toconnector base 603 and an unfixed end. The unfixed end of barb 620 mayinclude a sharp end configured to puncture a wall of a main vessel and aprotrusion configured to lock with a slot. To release the locking of theincision seal with connector 600, a surgeon may exert a force on theprotrusion causing barb 620 to unlock with the slot. In other examples,the above-described elements may be implemented differently and are notlimited to the examples shown and described.

FIG. 7 illustrates a top view of an exemplary sutureless vascularanastomosis connector. In some examples, connector 700 may be made of amemory material that allows connector 700 to change shape. Here,connector 700 includes connector body 702, body tines 712, 714, 716,717, and 718, barbs 720, 722, 724, and 726, side wings 721 and 725,front wing 730, rear wing 740, and wing tines 742, 744, 746, and 748.Connector body 702, body tines 712, 714, 716, 717, and 718, barbs 720,722, 724, and 726, side wings 721 and 725, front wing 730, and rear wing740 may be implemented similarly or substantially similar in functionand structure to like-named elements as shown and described in FIG. 2,FIG. 3, FIG. 5, and FIG. 6. As shown here, body tines 712, 714, 716,717, and 718, barbs 720, 722, 724, and 726, side wings 721 and 725,front wing 730, and rear wing 740 may be configured to deploy fromconnector 700.

As shown here, connector body 702 may include a tubular interior withinner diameter 770. Connector body 702 may be configured to transferfluids, such as blood, between two ends of connector 700. For example,connector body may be configured to transfer blood between a graftvessel and a main vessel. In other examples, connector body 700 may havea differently shaped hollow center.

Connector body 702 may also have a tubular exterior with outer diameter780. Outer diameter 780 may be configured to be substantially similar tothe diameter of an inner surface of the graft vessel. In some examples,body tines 712, 714, 716, 717, and 718, when deployed, may be configuredto extend from outer diameter 780 to tine diameter 790 and engage withthe inner surface of the graft vessel. When engaged with the innersurface of the graft vessel, body tines 712, 714, 716, 717, and 718 mayprovide a restraining force that restricts the movement of the graftvessel. The restraining force may be configured based upon theorientation of body tines 712, 714, 716, 717, and 718. In some examples,the restrictions in movement may be direction-orientated, thus allowingthe graft vessel to move in some directions but not in others. Here,body tines 712, 714, 716, 717, and 718 may be configured to have unfixedends pointing towards the connector base, thus provide a restrainingforce that prevents axial movements of connector 700 but allowslongitudinal movements of connector 700 towards the connector base. Inanother example, body tines 712, 714, 716, 717, and 718 may bepositioned uniformly around connector body 702 to provide a consistentrestraining force on the inner surface of the graft vessel. Theconsistent restraining force may be distributed evenly along the innersurface of the graft vessel, thus reducing the likelihood of tearscaused by undue stress on the inner surface of the graft vessel. Inother examples, the above-described elements may be implementeddifferently and are not limited to the examples shown and described.

FIG. 8 illustrates a front view of an exemplary incision seal. Incisionseal 800 may be configured to support the coupling between a graftvessel and a main vessel. As shown here, incision seal 800 includeslatching ports 802 and 804, base 810, and recess 820. In some examples,latching ports 802 and 804 may be configured to receive barbs (notshown) from a connector (not shown) to which incision seal 800 iscoupled, as described in greater detail below. As shown, recess 820 maybe located along the length of base 810. In other examples, recess 820may be shaped as a hollow channel, a tunnel, or other shaped opening. Asan example, recess 820 may be configured to receive a portion of anupper wall of the main vessel. The portion of the upper wall of the mainvessel may be protected or supported by incision seal 800 when theportion is received by recess 820. In an example, the recess may have acurvature that is substantially the same as the curvature of a portionof the upper outer wall of the main vessel. When incision seal 800 isplaced on the portion of the upper outer wall of the main vessel, therecess may sit flush with the portion of the upper outer wall of themain vessel, thus covering up the portion of the upper outer wall of themain vessel. In some examples, recess 820 may sit flush against anincision in the upper outer wall of the main vessel. When recess 820 isplaced flush against the incision, incision seal 800 may cover, protect,seal, or support the incision and the area surrounding the incision.Incision seal 800 may be made from synthetic materials such as plasticsor other elastomeric materials. In other examples, the above-describedelements and their design or function may be implemented differently andare not limited to the examples shown and described.

FIG. 9 illustrates a back view of an exemplary incision seal. Here,incision seal 900 may include base 910, recess 920, housing opening 930,and radius ring 940. In some examples, base 910 and recess 920 may beimplemented similarly or substantially similar in function and structureto like-named elements as shown and described in FIG. 8. Housing opening930 may be configured to receive a graft vessel. In some examples, thestructure of housing opening 930 may be a receptacle, hollow channel, orother hollow channel that intersects incision seal 900. Housing opening930 may provide a lumen for the graft vessel to be threaded throughincision seal 900. In some examples, housing opening 930 may have adiameter. The diameter may be adjusted to accommodate graft vessels ofvarious sizes. Alternatively, the diameter may be adjusted to change thefit of the graft vessel in housing opening 930. Here, housing opening930 may be a hollow cylindrical structure with a diameter approximatelyequal to the outer surface of a graft vessel. The hollow cylindricalstructure may provide a snug fit when the graft vessel is inserted intohousing opening 930.

In some examples, housing opening 930 may intersect recess 920, thuscoupling recess 920 with housing opening 930. This may provide a lumenfor objects inserted into housing opening 930 to reach recess 920, orvice versa. Here, housing opening 930 and recess 920 may be configuredto accommodate the junction of a graft vessel with a main vessel. Forexample, an incision of a main vessel may be covered by recess 920 whilea graft vessel inserted into housing opening 930 may reach an incisionin a main vessel. When a graft vessel is in contact with a main vessel,the two vessels may slowly graft together to form an integratedstructure. Incision seal 900 may protect or support the junction betweenthe graft vessel and the main vessel before the two vessels fully graftonto one another.

As shown here, housing opening 930 may further include radius ring 940along an entrance of housing opening 930. Radius ring 940 may beconfigured to ease the insertion of a graft vessel into housing opening930 by providing a larger aperture for insertion. In some examples,Radius ring 940 may have the same centerline as housing 930. In otherexamples, the above-described elements may be implemented differentlyand are not limited to the examples shown and described.

FIG. 10 illustrates a side view of an exemplary incision seal. Here,incision seal 1000 includes slots 1010 and 1020, latch pocket 1014 and1024, ports 1012 and 1022, and base 1050. In some examples, base 1050may be implemented similarly or substantially similar in function andstructure to like-named elements as shown and described in FIG. 8 andFIG. 9. Slot 1010 and slot 1020 may be configured to engage a pair ofbarbs to secure a connector with incision seal 1000. As shown here, slot1010 may include port 1012 and latch pocket 1014. Port 1012 may beconfigured to receive a barb (not shown). After the barb is received byport 1012, a barb may engage with latch pocket 1014, thus locking thebarb in place. For example, a portion of a barb may be seated on latchpocket 1014, thus preventing the barb from retracting through port 1012.Once the barb is locked, incision seal 1000 may be securely coupled tothe connector. As an example, a barb may automatically engage with latchpocket 1014 once the barb has been inserted into port 1012 by apre-determined amount. To uncouple incision seal 1000 from theconnector, a force may be applied to a barb to disengage the barb fromlatch pocket 1014 thus allowing the barb to retract through port 1012.Structurally, port 1012 and latch pocket 1014 may be a variety ofshape's including square, rectangular, triangular, and semi-circular, toname a few. In some examples, slot 1020 may include port 1022 and latchpocket 1024. Port 1022 and latch pocket 1024 may be implementedsimilarly or substantially similar in function and structure as port1012 and latch pocket 1014 as described above.

In some examples, the configuration of slots 1010 and 1020 in incisionseal 1000 may vary depending on application. As an example, the numberof slots used to securely couple incision seal 1000 with a connector(not shown) may vary. In general, incision seal 1000 may be moresecurely coupled with the connector when incision seal 1000 includesmore slots. However, additional slots may increase the difficulty tounlock a connector from incision seal 1000. As another example, theorientation of slots 1010 or 1020 may also be varied. As shown here,slot 1010 and slot 1020 may be configured to have port 1012 and port1022 closer to one another than latch pocket 1014 and latch pocket 1024.In other words, slot 1010 and slot 1020 may be oriented in differentdirections. In some examples, an independent force may be applied tounlock each slot. Thus, two forces applied in different directions maybe used to unlock the connector from incision seal 1000 when slot 1010and slot 1020 are oriented in different directions. For example, slot1010 may require a force in the direction of latch pocket 1014 to port1012 to unlock the barb from slot 1010. Similarly, slot 1020 may requirea force in the direction of latch pocket 1024 to port 1022 to unlock thebarb from slot 1020. These different forces may decrease the likelihoodthat the connector accidentally unlocks from incision seal 1000. Inother examples, the above-described elements may be implementeddifferently and are not limited to the examples shown and described.

FIG. 11 illustrates a perspective view of an exemplary incision seal. Asshown here, incision seal 1100 may include recess 1150, slots 1152 and1154, groove 1110, guide 1112, guide 1114, slot 1122, and slot 1124.Recess 1150, slot 1122, and slot 1124 may be implemented similarly orsubstantially similar in function and structure to like-named elementsas shown and described in FIG. 8 and FIG. 9, and FIG. 10. Groove 1110may be configured to receive a connector (not shown). Once received, theconnector may lock with incision seal 1100 using slot 1122 and slot1124. In an example, the connector may be securely coupled with incisionseal 1100 when barbs belonging to a connector are inserted into andlocked with slot 1122 and slot 1124. In another example, a connector andincision seal 1100 may create a clamping force on a wall of a vesselwhen the connector is locked with the incision seal. This clamping forcemay securely couple the end of the graft vessel to an incision in thewall of a main vessel. Securely coupling the two vessels together mayprevent fluids from leaking at the junction or provide support for thejunction. Over time, the graft vessel and the main vessel may graft withone another, thus forming an integrated vessel. In some examples, groove1110 may be formed by removing a portion of incision seal 1100 fromrecess 1150. In other examples, groove 1110 may be formed by removing aportion of incision seal 1100 from a lumen in incision seal 1110.

As shown here, incision seal 1100 may also include guide 1112 and guide1114. Guide 1112 and guide 1114 may be configured to guide a barb, apart of a fastener, or other locking component from the connector toincision seal 1100. Structurally, guide 1112 and guide 1114 may be atrench, channel, or other cut-out along groove 1110. In an example,guide 1112 and guide 1114 may be parallel with one another and bedisposed along two edges of groove 1110. In some examples, guide 1112may intersect slot 1122. A barb or other locking component travelingalong guide 1112 may enter slot 1122. In other words, guide 1112 mayguide the barb, the part of a faster, or other locking component intoslot 1122 where the two may mate or lock with one another. Similarly,guide 1114 may intersect slot 1124 and be configured to guide a barb orother locking component into slot 1124 where the two may mate or lockwith one another. In other examples, the above-described elements may beimplemented differently and are not limited to the examples shown anddescribed.

FIGS. 12-31 illustrate exemplary processes for coupling a graft vesselto a main vessel. For example, the process shown in FIG. 12 to FIG. 31may be used to perform a sutureless vascular anastomosis procedure usinga connector, incision seal, and other elements as shown and describedherein. In some examples, these processes may be performed in the ordershown or any variation thereof. In other examples, other processes (notshown) may also be performed. In yet other examples, other processes forcoupling a graft vessel to a main vessel may use some or all of thetechniques illustrated in FIG. 12 to FIG. 31.

FIG. 12 illustrates an exemplary incision seal receiving a graft vessel.Here, system 1200 may include graft vessel 1210 and incision seal 1220.In some examples, incision seal 1220 may be implemented similarly orsubstantially similar in function and structure as like-named objectsshown in FIG. 8 to FIG. 11. A surgeon may insert and thread graft vessel1210 through a housing in incision seal 1220. In an example, the housingmay include a recessed ring. In some examples, graft vessel 1210 may bethreaded through incision seal 1220 to keep incision seal 1220 away fromthe end of graft vessel 1210. This may allow the surgeon to operate onthe end of graft vessel 1210 without interference from incision seal1220. In other examples, the above-described elements may be implementeddifferently and are not limited to the examples shown and described.

FIG. 13 illustrates an end of a graft vessel receiving an exemplarysutureless vascular anastomosis connector. Here, system 1300 may includegraft vessel end 1310, connector 1320, and sheath 1330. Connector 1320may be implemented similarly or substantially similar in function andstructure as like-named objects shown in FIG. 2 to FIG. 7. Connector1320 may be partially covered by sheath 1330. As an example, sheath 1330may provide a restraining force on a connector base of connector 1320 toprevent wings or barbs of the connector base from deploying. In anotherexample, sheath 1330 may provide a surface for a surgeon to grasp whenhandling connector 1320. The surgeon may hold connector 1320 by sheath1330 while inserting connector 1320 into graft vessel end 1310. In someexamples, the tip of connector 1320 may be contractible to ease the taskof inserting connector 1320 into graft vessel end 1310. In otherexamples, connector 1320 may be securely coupled to graft vessel end1310 when inserted. For example, the body of connector 1320 may includeretention spikes (i.e. tines) to securely engage the inner wall of thegraft vessel. Once the retention spikes are engaged, connector 1320 maybe securely coupled to graft vessel end 1310.

As shown here, sheath 1330 may include orientation guide 1335.Orientation guide 1335 may be configured to guide the insertion ofconnector 1320 into graft vessel end 1310 in the direction of the arrowshown. In some examples, graft vessel end 1310 and sheath 1330 may bothcontain an angular end. For example, graft vessel end 1310 and sheath1330 may both contain an end at, for example, a 45-degree angle. Inother examples, the degree of orientation may be varied and is notlimited to 45 degrees. Orientation guide 1335 may help ensure that theangular end of graft vessel end 1310 aligns with the angular end ofsheath 1330 by placing a point of reference along the exterior of sheath1330. This point of reference may assist a surgeon in orientingconnector 1310 during the insertion of connector 1320 into graft vesselend 1310. Properly inserting connector 1320 into graft vessel end 1310may ensure that connector 1320 may be successfully deployed later on. Inother examples, the above-described elements may be implementeddifferently and are not limited to the examples shown and described.

FIG. 14 illustrates a side and cross-sectional view of loading anexemplary sutureless vascular anastomosis connector into an introducer.Here, system 1400 includes graft vessel 1410, connector 1420, sheath1430, orientation guide 1435, introducer 1440, and tool 1450. Connector1420 and sheath 1430 may be implemented similarly or substantiallysimilar in function and structure as like-named objects shown in FIG. 2to FIG. 7 and FIG. 13. Connector 1420 may be disposed within andsecurely coupled with graft vessel 1410 and sheath 1430. Moving one ofthese coupled elements may result in similar movements from the othercoupled elements. Introducer 1440 may be configured to receive connector1420 and insert connector 1420 into a main vessel. As shown here,introducer 1440 may include lumen 1442 configured to receive graftvessel 1410, connector 1420, sheath 1430, or other object. Introducer1440 may also include tip 1445 disposed on one end of lumen 1442. Tip1445 may have an end that includes one or more slits configured toremain closed when in a resting state and open when a force is applied.

Here, sheath 1430 may be loaded into introducer 1440. This may includeinserting sheath 1430 into an opening of introducer 1440, such as lumen1442. In some examples, sheath 1430 may include orientation guide 1435.Orientation guide 1435 may be configured to orient sheath 1430 beforeinsertion into lumen 1442. By orienting sheath 1430, connector 1420 mayalso be oriented since sheath 1430 is coupled to connector 1420. Thus,connector 1420 may also be oriented before insertion into lumen 1442. Asan example, orientation guide 1435 may be aligned with an index key ofintroducer 1440 (not shown). When orientation guide 1435 is insertedinto the index key, sheath 1430 or connector 1420 may be successfullyoriented with respect to introducer 1440. In other examples, theabove-described elements may be implemented differently and are notlimited to the examples shown and described.

FIG. 15 illustrates another side and cross-sectional view of loading anexemplary sutureless vascular anastomosis connector into an exemplaryintroducer. Here, system 1500 includes graft vessel 1510, connector1520, sheath 1530, introducer 1540, tip 1545, and tool 1550. Connector1520, sheath 1530, introducer 1540, and tip 1545 may be implementedsimilarly or substantially similar in function and structure aslike-named elements shown in FIG. 2 to FIG. 7 and FIG. 13 to FIG. 14.Connector 1520 may be disposed within and securely coupled with graftvessel 1510 and sheath 1530. Thus, moving one of these coupled elementsmay result in similar movements from the other coupled elements. As anexample, connector 1520 may be securely coupled to graft vessel 1510 byretention spikes (i.e. tines) of connector 1520. In another example,connector 1520 may be securely coupled to sheath 1530 by a restrictiveforce created from wedging connector 1520 and sheath 1530 throughintroducer 1540.

As shown here, a force may be applied to sheath 1530 to insert sheath1530 into an opening of introducer 1540. In some examples, sheath 1530may enter the opening, pass through a lumen of introducer 1540, and exitan end of tip 1545. As sheath 1530 is inserted into introducer 1540,sheath 1530 may remain securely coupled to connector 1520. As anexample, connector 1520 may have retention spikes (i.e. tines) thatsecurely contact the inner surface of sheath 1530 due to a restrainingforce provided by the wall of the lumen. When sheath 1530 contacts theend of tip 1545, the applied force may cause tip 1545 to open andaccommodate sleeve 1530. This may leave an exposed portion of sleeve1530 outside the end of tip 1545. As sheath 1530 is further insertedinto the opening of introducer 1540, tip 1545 may expand or retract toaccommodate the outer surface of sleeve 1530 while the exposed portionof sleeve 1530 may increase. In some examples, the exposed portion maybe grasped and pulled. Pulling sheath 1530 may result in the coupledconnector 1520 and graft vessel 1510 to also be pulled towards tip 1545.When sheath 1530 exits the end of introducer 1540, connector 1520 andgrafting vessel 1510 may be properly seated in introducer 1540. In otherexamples, the above-described elements may be implemented differentlyand are not limited to the examples shown and described.

FIG. 16 illustrates a further side and cross-sectional view of exemplarysutureless vascular anastomosis connector loaded into an exemplaryintroducer. Here, system 1600 includes graft vessel 1610, connector1620, introducer 1640, tip 1645, and tool 1650. Connector 1620,introducer 1640, and tip 1645 may be implemented similarly orsubstantially similar in function and structure as like-named objectsshown and described in FIG. 2 to FIG. 7 and FIG. 13 to FIG. 15. As shownhere, graft vessel 1610 may be disposed within introducer 1640 so thatan angled end of graft vessel 1610 may be parallel with an exteriorsurface of introducer 1640. Moreover, connector 1620 may be disposedwithin introducer 1640 and reside within tip 1645. Tip 1645 may beconfigured to shield connector 1620 during insertion into the mainvessel. Using tool 1650, tip 1645 may be used to prevent retentionspikes (i.e. tines), barbs, or other elements of connector 1620 fromimproperly engaging the main vessel during insertion. In other examples,the above-described elements may be implemented differently and are notlimited to the examples shown and described.

FIG. 17 illustrates a side and cross-sectional view of an exemplaryintroducer entering an incision in a main vessel. Here, system 1700 mayinclude graft vessel 1710, main vessel 1720, incision 1725, tool 1730,introducer 1740, and tip 1745. In some examples, introducer 1740 and tip1745 may be implemented similarly or substantially similar in functionand structure as like-named objects shown and described in FIG. 13 toFIG. 16. Graft vessel 1710 may be securely coupled to a connector (notshown). The connector may be configured to be inserted and securelycoupled to a main vessel to join the main vessel with graft vessel 1710.Thus, the connector may serve as the coupling component to couple graftvessel 1710 with main vessel 1720. Here, introducer 1740 may beconfigured to insert the connector into the main vessel. Introducer1740, while housing graft vessel 1710 and the connector, may be insertedinto incision 1725 at an angle. As an example, tip 1745 of introducer1740 may be inserted into incision 1725. In other examples, theabove-described elements may be implemented differently and are notlimited to the examples shown and described.

FIG. 18 illustrates a side and cross-sectional view of an exemplaryintroducer disposed within an incision in a main vessel. As shown here,system 1800 may include graft vessel 1810, main vessel 1820, incision1825, introducer 1840, and tip 1845. Introducer 1840 and tip 1845 may beimplemented similarly or substantially similar in function and structureas like-named objects shown and described in FIG. 13 to FIG. 17. An endof graft vessel 1810 may be securely coupled to a connector (not shown),where the end of graft vessel 1810 and the connector are both housedwithin introducer 1840. Here, introducer 1840 may be inserted intoincision 1825 of main vessel 1820. As an example, tip 1845 of inserter1840 may be disposed within main vessel 1820 when introducer 1840 isinserted. This may cause a surface of inserted introducer 1840 to abut aportion of the wall of main vessel 1820 surrounding incision 1825. Insome examples, a diameter of tip 1845 may be approximately the same as adiameter of graft vessel 1810. In other examples, the above-describedelements may be implemented differently and are not limited to theexamples shown and described.

FIG. 19 illustrates a side and cross-sectional view of an exemplaryintroducer inserting an exemplary sutureless vascular anastomosisconnector inside a main vessel. As shown here, system 1900 may includegraft vessel 1910, main vessel 1920, incision 1925, introducer 1940, tip1945, connector 1950, deployment rod 1960, and tool 1970. Introducer1940, tip 1945, and connector 1950 may be implemented similarly orsubstantially similar in function and structure as like-named objectsshown and described in FIG. 2 to FIG. 7 and FIG. 13 to FIG. 18.Introducer 1940 may be configured to insert or introduce connector 1950into main vessel 1920. For example, tip 1945 of introducer 1940 may beinserted into incision 1925 and a surface of introducer 1940 may overlapan exterior surface surrounding incision 1925. In other words,introducer 1940 may be positioned so that tip 1945 is inserted intoincision 1925 of main vessel 1920 and a surface of introducer 1940 isaligned with or flush against a wall of main vessel 1920. Introducer1940 may remain in this position during the insertion or introduction ofconnector 1950 into main vessel 1920.

In some examples, connector 1950 and graft vessel 1910 may be pushedthrough introducer 1940. As an example, rod 1960 may serve as aninsertion instrument configured to contact connector 1950 to pushconnector 1950 towards tip 1945. In an example, connector 1950 may bepushed through introducer 1940, extend out of tip 1945, and enter intomain vessel 1920. As connector 1950 extends out of tip 1945, tip 1945may expand to accommodate connector 1950. In some examples, connector1950 may be inserted into main vessel 1920 while introducer 1940 remainsflush against a wall of main vessel 1920 with tip 1945 inserted intomain vessel 1920. In other examples, the above-described elements may beimplemented differently and are not limited to the examples shown anddescribed.

FIG. 20 illustrates a side and cross-sectional view of an exemplaryintroducer deploying an exemplary sutureless vascular anastomosisconnector in a main vessel. As shown here, system 2000 may include graftvessel 2010, main vessel 2020, incision 2025, introducer 2040, tip 2045,connector 2050, front wing 2052, rear wing 2054, barb 2036, and tool2070. Introducer 2040, tip 2045, and connector 2050, front wing 2052,rear wing 2054, and barb 2036 may be implemented similarly orsubstantially similar in function and structure as like-named objectsshown and described in FIG. 2 to FIG. 7 and FIG. 13 to FIG. 19.Introducer 2040 may be configured to insert or introduce connector 2050in main vessel 2020. In some examples, this may be a two step process.In a first step, tip 2045 may be inserted within main vessel 2020 withconnector 2050 located within tip 2045. In a second step, tip 2045 maybe retracted from main vessel 2020 while leaving connector 2050 withinmain vessel 2020.

As shown here, rod 2060 may be configured to control the position ofconnector 2050. In some examples, a pushing force may be applied to rod2060 to change the position of connector 2050 with respect to mainvessel 2020. For example, the pushing force may cause rod 2060 tocontact and push connector 2050 further into main vessel 2020. Thecontact point may be a wing, a tine, a barb, or other slight protrusionalong the exterior surface of connector 2050. In other examples, amaintaining force may be applied to rod 2060 to maintain the position ofconnector 2050 in main vessel 2020. For example, the maintaining forcemay be applied to rod 2060 to maintain the position of connector 2050while a lifting force may be applied to introducer 2040 to removeintroducer 2040 away from main vessel 2020. When the lifting force isapplied, introducer 2040 and tip 2045 may travel along the shaft ofgraft vessel 2010 away from main vessel 2020. This may cause tip 2045 toexpand or reduce to accommodate the exterior surface of connector 2050and graft vessel 2010. For example, tip 2045 may expand to approximatelythe same circumference as graft vessel 2010. As tip 2045 is retractedfrom main vessel 2020, connector 2050 may be exposed from an end of tip2045 and remain within main vessel 2020. Eventually, connector 2050 maybe entirely exposed from tip 2045 and disposed inside main vessel 2020.

In some examples, tip 2045 may apply a restraining force on connector2050. The restraining force may prevent front wing 2052, rear wing 2054,and barb 2036 from deploying while connector 2050 is disposed within tip2045. As tip 2045 is removed from main vessel 2020, a portion ofconnector 2050 may become exposed from an end of tip 2045. The exposedportion may be relieved from the restraining force. Thus, front wing2052, rear wing 2054, and barb 2036 may deploy from connector 2050 oncethey belong to the exposed portion. Once deployed, these elements maysecurely engage with an interior surface of main vessel 2020. In otherexamples, the above-described elements may be implemented differentlyand are not limited to the examples shown and described.

FIG. 21 illustrates an exemplary introducer encompassing a graft vessel.As shown here, system 2100 may include graft vessel 2110, main vessel2120, introducer 2140, and slit 2141. Introducer 2140 may be implementedsimilarly or substantially similar in function and structure aslike-named objects shown and described in FIG. 14 to FIG. 20. Aby-product of coupling an end of graft vessel 2110 with a side of mainvessel 2120 may be introducer 2140 encompassing graft vessel 2110. Itmay be desirable to remove introducer 2140 from graft vessel 2110 sothat an incision seal may be lowered onto main vessel 2120 and used toseal the coupling of graft vessel 2110 with main vessel 2120.

Introducer 2140 may include slit 2141. Slit 2141 may be configured toremove introducer 2140 from graft vessel 2110 by splitting introducer2140 into multiple parts. In other words, slit 2141 may provide a meansfor splitting and removing introducer 2140 from graft vessel 2120. Here,slit 2141 may be disposed on a plane that bisects introducer 2140 intotwo equal parts. When a detaching force is applied to introducer 2140,introducer 2140 may split into two equal parts along slit 2141. In otherexamples, multiple slits may be disposed along multiple planes ofintroducer 2140. These multiple slits may divide introducer 2140 intomultiple parts when a detaching force is applied. In yet other examples,the above-described elements may be implemented differently and are notlimited to the examples shown and described.

FIG. 22 illustrates an exemplary introducer detaching from a graftvessel. As shown here, system 2200 may include graft vessel 2210, mainvessel 2220, introducer part 2242 and introducer part 2244. Initially,an introducer may be encompassing graft vessel 2210. After a detachingforce is applied, the introducer may split along a plane intersectingthe introducer to form introducer part 2242 and introducer part 2244.Once split, introduce part 2242 and introducer part 2244 may no longerencompass graft vessel 2210 and thus, may be removed system 2200. Inother examples, the above-described elements may be implementeddifferently and are not limited to the examples shown and described.

FIG. 23 illustrates an exemplary barb-setting device. Here, system 2300may include graft vessel 2310, main vessel 2320, incision seal 2330, andbarb-setting device 2340. In some examples, barb-setting device 2340 mayalso be referred to as a “tool.” As shown, incision seal 2330 may beimplemented similarly or substantially similar in function and structureas like-named objects shown and described in FIG. 8 to FIG. 11. As shownhere, barb-setting device 2340 may be in an open position. Barb-settingdevice 2340 may be configured to cause one or more barbs belonging to aconnector within main vessel 2320 to puncture a wall of the main vessel.The punctured barbs may subsequently lock with incision seal 2330.Structurally, barb-setting device 2340 may include two components hingedtogether in a similar fashion as a traditional pair of pliers. The firstcomponent may include an end having a semi-cylindrical structureconfigured to longitudinally receive main vessel 2320. In an example,the semi-cylindrical structure may further include one or more openingsconfigured to accommodate one or more barbs. In another example, thesemi-cylindrical structure may be slotted on one end to receive graftvessel 2310. The slot may allow the junction between graft vessel 2310and main vessel 2320 to be disposed in the middle of thesemi-cylindrical structure. This may result in more uniform distributionof force on graft vessel 2310 and main vessel 2320 when a clenchingforce is applied to barb-setting device 2340. The second component ofbarb-setting device 2340 may also be configured to longitudinallyreceive main vessel 2320. Together, the first component and secondcomponent may clench main vessel 2320 thus causing one or more barbs topierce the main vessel. In some examples, barb-setting device 2340 mayalso securely engage wings or tines of the connector with an innersurface of the main vessel. In other examples, the above-describedelements may be implemented differently and are not limited to theexamples shown and described.

FIG. 24 illustrates a cross-sectional view of an exemplary barb-settingdevice. Here, system 2400 may include graft vessel 2410, main vessel2420, connector 2430, barb-setting device 2440, opening 2442 and opening2444. In some examples, connector 2430 and barb-setting device 2440 maybe implemented similarly or substantially similar in function andstructure as like-named objects shown and described in FIG. 2 to FIG. 7,FIG. 13 to FIG. 16, FIG. 19 to FIG. 20, and FIG. 23. As shown here,barb-setting device 2440 may be in an open position. Barb-setting device2440 may be configured to cradle the junction between graft vessel 2410and main vessel 2420. Connector 2430 may be disposed within main vessel2420 and securely coupled to graft vessel 2410. In some examples,barb-setting device 2440 may be configured to apply a clenching force onthe exterior surface of main vessel 2420 that causes barbs, wings, orretention spikes (i.e. tines) of connector 2430 to engage with an innersurface of main vessel 2420. For example, an upper portion ofbarb-setting device 2440 may be configured to receive an upper wall ofmain vessel 2420. The upper portion may also include opening 2442 andopening 2444 through which barbs of a connector (not shown) may beinserted. Opening 2442 and opening 2444 may be configured to accommodateone or more barbs that pierce the upper wall of main vessel 2420 whenthe clenching force is applied. In another example, a lower portion ofbarb-setting device 2440 may be configured to compress a bottom wall ofmain vessel 2420. When compressed, the interior surface of the bottomwall of main vessel 2420 may contact connector 2430, thus causing barbsof connector 2430 to puncture main vessel 2420. In other examples, theabove-described elements may be implemented differently and are notlimited to the examples shown and described.

FIG. 25 illustrates an exemplary barb-setting device. Here, system 2500may include graft vessel 2510, main vessel 2520, incision seal 2530, andbarb-setting device 2540. In some examples, incision seal 2530 andbarb-setting device 2540 may be implemented similarly or substantiallysimilar in function and structure as like-named objects shown anddescribed in FIG. 8 to FIG. 11, FIG. 23, and FIG. 24. As shown here,barb-setting device 2540 may be in a closed position. Barb-settingdevice 2540 may be configured to apply a clenching force to main vessel2520. In some examples, the clenching force may cause one or more barbsof a connector disposed within main vessel 2520 to puncture a wall ofmain vessel 2520. In other examples, the above-described elements may beimplemented differently and are not limited to the examples shown anddescribed.

FIG. 26 illustrates a cross-sectional view of a barb-setting device.Here, system 2600 may include graft vessel 2610, main vessel 2620,connector 2630, barb 2632, barb 2634, barb-setting device 2640, opening2642 and opening 2644. In some examples, connector 2630, barb 2632, andbarb-setting device 2640 may be implemented similarly or substantiallysimilar in function and structure as like-named objects shown anddescribed in FIG. 2 to FIG. 7, FIG. 13 to FIG. 16, FIG. 19 to FIG. 20,and FIG. 23 to FIG. 25. As shown here, barb-setting device 2640 may bein a closed position. Barb-setting device 2640 may be configured toprovide a clenching force on the outer surface of main vessel 2620causing main vessel 2620 to deform, compress, or otherwise change shape.Connector 2630 may be disposed within main vessel 2620 and securelycoupled to graft vessel 2610. In some examples, main vessel 2620 mayassume a shape that is substantially the same as the inner surface ofthe upper and lower components of barb-setting device 2640. In otherexamples, main vessel 2620 may assume other shapes. When in a compressedstate, an inner surface of main vessel 2620 may contact connector 2630,thus causing connector 2630 to engage an inner surface of an upper wallof main vessel 2620. For example, a wing of connector 2630 may engage aninner surface of main vessel 2620 when main vessel 2620 is in acompressed state. In another example, barb 2632 and barb 2634 ofconnector 2630 may puncture a wall of main vessel 2620 when main vessel2620 is in a compressed state. The punctured barbs may be disposedwithin opening 2642 and opening 2644 of barb-setting device 2640. Whenthe clenching force is removed, main vessel 2620 may return to itsoriginal shape while connector 2630 remains engaged with an innersurface of an upper wall of main vessel 2620. For example, barb 2632 andbarb 2634 may remain protruding from the exterior surface of main vessel2620. In another example, wings or tines of connector 2630 may remainengaged with an inner surface of an upper wall of the main vessel. Inyet other examples, the above-described elements may be implementeddifferently and are not limited to the examples shown and described.

FIG. 27 illustrates an exemplary incision seal-setting device. System2700 may include graft vessel 2710, main vessel 2720, incision seal2730, and incision seal-setting device 2740. Incision seal 2730 may beimplemented similarly or substantially similar in function and structureas like-named objects shown and described in FIG. 8 to FIG. 11. As shownhere, incision seal-setting device 2740 may be in an open position.Incision seal-setting device 2740 may be configured to lock incisionseal 2730 with a connector disposed within main vessel 2720. Incisionseal 2730 may support graft vessel 2710 by encompassing graft vessel2710. Incision seal 2730 may also cover a junction between graft vessel2710 and main vessel 2720. Structurally, incision seal-setting device2740 may include two components hinged together in a similar fashion asa traditional pair of pliers. The first component may include an endhaving a semi-cylindrical structure configured to longitudinally receivemain vessel 2720 and incision seal 2730. In an example, thesemi-cylindrical structure may be slotted on one end to receive graftvessel 2710 and incision seal 2730. The slot may allow the junctionbetween graft vessel 2710 and main vessel 2720 to be disposed in themiddle of the semi-cylindrical structure. The second component ofincision seal-setting device 2740 may also be configured tolongitudinally receive main vessel 2720. Together, the first componentand second component may clench together incision seal 2730 with aconnector within main vessel 2720, thus causing one or more barbs tolock with incision seal 2730. In some examples, the integrated structure(i.e., first and second components, incision seal 2730, and a connector(not shown)) may provide a clamping force on the portion of the mainvessel between incision seal 2730 and the connector. In other examples,the above-described elements may be implemented differently and are notlimited to the examples shown and described.

FIG. 28 illustrates a cross-sectional view of an exemplary incisionseal-setting device. Here, system 2800 is a general illustration thatincludes graft vessel 2810, main vessel 2820, incision seal 2830,incision seal-setting device 2840, connector 2850, barb 2852, and barb2854. In some examples, incision seal 2830, incision seal-setting device2840, connector 2850, barb 2852, and barb 2854 may be implementedsimilarly or substantially similar in function and structure aslike-named objects shown and described in FIG. 2 to FIG. 16, FIG. 19 toFIG. 20, and FIG. 23 to FIG. 27. As shown here, incision seal-settingdevice 2840 may be in an open position. Incision seal 2830 may bedisposed in a position allowing barb 2852 and barb 2854 of connector2850 to lock with incision seal 2830 when a clenching force is appliedto incision seal-setting device 2840. In some examples, an inner surfaceof incision seal-setting device 2840 may be configured to receiveincision seal 2830 and main vessel 2820. In other examples, an innersurface of incision seal setting device 2840 may be configured todeform, compress, or otherwise change the shape of main vessel 2820. Inyet other examples, the above-described elements may be implementeddifferently and are not limited to the examples shown and described.

FIG. 29 illustrates an exemplary incision seal-setting device. Here,system 2900 may include graft vessel 2910, main vessel 2920, incisionseal 2930, and incision seal setting device 2940. In some examples,incision seal 2930 and incision seal-setting device 2940 may beimplemented similarly or substantially similar in function and structureas like-named objects shown and described in FIG. 8 to FIG. 11 and FIG.27 to FIG. 28. As shown here, incision seal setting device 2940 may bein a closed position. Incision seal setting device 2940 may beconfigured to apply a clenching force on main vessel 2920, incision seal2930, and a connector within main vessel 2920. When the clenching forceis applied, incision seal 2930 may lock with the connector. In someexamples, incision seal 2930 and the connector may create a clampingforce when locked. The clamping force may securely couple graft vessel2910 to main vessel 2920. In some examples, the clenching force mayaffect a portion of main vessel 2920 overlapping incision seal 2930. Inother examples, the clenching force may have no affect on portions ofmain vessel 2920 that do not overlap incision seal 2930. In yet otherexamples, the above-described elements may be implemented differentlyand are not limited to the examples shown and described.

FIG. 30 illustrates an exemplary incision seal setting device. Here,system 3000 may include graft vessel 3010, main vessel 3020, incisionseal 3030, incision seal setting device 3040, connector 3050, barb 3052,and barb 3054. In some examples, incision seal 3030, incision sealsetting device 3040, connector 3050, barb 3052, and barb 3054 may beimplemented similarly or substantially similar in function and structureas like-named objects shown and described in FIG. 2 to FIG. 16, FIG. 19to FIG. 20, and FIG. 23 to FIG. 29. As shown here, incision seal settingdevice 3040 may be in a closed position when a clenching force isapplied. Incision seal setting device 3040 may be configured to lockconnector 3050 with incision seal 3030. For example, incision sealsetting device 3040 may compress main vessel 3020 to cause barb 3052 andbarb 3054 to lock with incision seal 3030. In some examples, an interiorsurface of incision seal setting device 3040 may be configured to causemain vessel 3020 to deform, compress, or otherwise change shape. Inother examples, the above-described elements may be implementeddifferently and are not limited to the examples shown and described.

FIG. 31 illustrates an exploded view of an exemplary two-componentsutureless vascular anastomosis connector system. Here, system 3100 mayinclude graft vessel 3110, main vessel 3120, incision seal 3130, andconnector 3140. System 3100 may be configured to couple an end of graftvessel 3110 with incision 3190 along a wall of main vessel 3120. In someexamples, incision seal 3130 and connector 3140 may be implementedsimilarly or substantially similar in function and structure aslike-named objects shown and described in FIG. 2 to FIG. 16, FIG. 19 toFIG. 20, and FIG. 23 to FIG. 29. As shown here, graft vessel 3110 may be“sandwiched” (i.e., disposed between) in between incision seal 3130 aidconnector 3140. In some examples, graft vessel 3110 may be securely heldin between connector 3140 and incision seal 3130 when connector 3140 isin a deployed state (as shown in FIG. 31).

Main vessel 3120 may also be “sandwiched” (i.e., disposed between) inbetween incision seal 3130 and connector 3140 when connector 3140 isdisposed within main vessel 3120. Connector 3140 and incision seal 3130may be interlocked to provide a securing force that couples theconnector 3140 to incision seal 3130. For example, the interlock mayprovide a securing force that secures main vessel 3120 in betweenconnector 3140 and incision seal 3130. In some examples, connector 3140may also provide a restraining force on the inner wall of main vessel3120 that helps maintain the position of the wall of the main vesselrelative to connector 3120. In yet another example, the interlock mayprovide sufficient pressure to minimize leakage from the end of graftvessel 3110, the incision in main vessel 3120, or any holes on the wallof the main vessel that may be covered by incision seal 3130. In otherexamples, the above-described elements may be implemented differentlyand are not limited to the examples shown and described.

FIG. 32 illustrates an exploded view of an exemplary three-componentsutureless vascular anastomosis connector system. Here, system 3200 mayinclude graft vessel 3210, main vessel 3220, incision seal 3230,connector 3240, and support tube 3250. In some examples, incision seal3230 and connector 3240 may be implemented similarly or substantiallysimilar in function and structure as like-named objects shown anddescribed in FIG. 2 to FIG. 16, FIG. 19 to FIG. 20, and FIG. 23 to FIG.29. System 3200 may be configured to couple an end of graft vessel 3210with incision 3290 along a wall of main vessel 3220. As shown here,graft vessel 3210 may be sandwiched in between support tube 3250 andconnector 3240. In some examples, graft vessel 3210 may be securely heldin between connector 3240 and support tube 3250 when connector 3240 isdeployed (as shown in FIG. 32). Incision seal 3230 may be configured toreceive support tube 3250 and securely couple with connector 3240 whenconnector 3240 is disposed within main vessel 3220. This may minimizeleakage from being generated at or near the junction of the two vesselsby providing additional support to the junction. For example, an end ofsupport tube 3250 may firmly press the end of graft vessel 3240 againstthe wall of main vessel 3220 when incision seal 3230 is securely coupledwith connector 3240. This may minimize leakage at the junction betweenthe two vessels. As another example, incision seal 3230 may firmly coveran area of the wall of main vessel 3220 when incision seal 3230 issecurely coupled with connector 3240. This may minimize leakage fromholes in the area of the wall of main vessel 3220. In other examples,the above-described elements may be implemented differently and are notlimited to the examples shown and described.

FIG. 33 illustrates an exemplary support tube. Here, support tube 3300may include body 3310, ring 3320, and notch 3330. Support tube 3300 maybe configured to secure a graft vessel firmly to a main vessel. This mayminimize leakage from the junction of the two vessels. As shown here,body 3310 may comprise of a hollow tube having an inner diameter and anouter diameter. The dimensions of body 3310 may be configured to allowbody 3310 to be disposed in between a graft vessel and an incision seal.In some examples, the incision seal may be may be implemented similarlyor substantially similar in function and structure to like-namedelements as shown and described in FIG. 34. As an example, the innerdiameter may be substantially similar to the outer diameter of the graftvessel, thereby allowing the graft vessel to fit snug within supporttube 3300. As another example, the outer diameter may be configured suchthat body 3310 fits snug within a lumen in between first housing opening3430 and second housing opening 3440 of incision seal 3400. In someexamples, body 3310 may include an angled end. The angled end may beconfigured so that support tube 3300 may securely contact a wall of amain vessel at a pre-determined angle. As an example, the angled end mayhave substantially the same angle as an end of a graft vessel. The endof the graft vessel may be aligned with the angled end to allow the endof the graft vessel and support tube 3300 to securely contact the wallof the main vessel at the predetermined angle. In some examples, theangle at the end of the graft vessel, the angled end of body 3310, andan angle of a housing of an incision seal may all be substantially thesame. This may allow all three to securely contact the wall of the mainvessel.

In some examples, the length of body 3310 may be configured as a unit ofmeasurement. For example, the length of body 3310 may be used as a guideto measure the approximate length of the portion of the graft vessel tobe secured to a connector. This may be useful during the preparation ofthe graft vessel for vascular anastomosis (as discussed in FIG. 37). Asan example, the length of body 3310 may be proportionate to the lengthof a portion of the connector to be coupled to the graft vessel. Thus,the length of body 3310 may be utilized as a measurement for determininga portion of the graft vessel that will be coupled to the connector. Insome examples, the portion of the graft vessel measured may be foldedover the exterior surface of body 3310 to subsequently be used to couplewith the connector.

Support tube 3300 may further include ring 3320. Ring 3320 may bedisposed along a circumference of body 3310. As an example, ring 3320may be configured to couple with incision seal 3400. For example, ring3320 may couple with groove 3450 of incision seal 3400 when support tube3300 is received by incision seal 3400. When coupled, forces applied toincision seal 3400 may also be applied to support tube 3300. Forexample, a securing force applied to incision seal 3400 may also pushsupport tube 3300 towards a wall of the main vessel. This may result insupport tube 3300 firmly pressing an end of a graft vessel against thewall of the main vessel. In some examples, this may minimize leakage atthe junction of the graft vessel and the main vessel. As an example,ring 3320 may be disposed along the outer surface of body 3310 dependingon the location of groove 3450. For example, ring 3320 may be disposedat a position allowing incision seal 3400 and support tube 3300 tocontact the wall of the main vessel when ring 3320 is coupled to groove3450.

Support tube 3300 may further include notch 3330. Notch 3330 may becoupled to an angled end of body 3310 and may be configured to provideclearance for deployment of a wing belonging to a connector. In someexamples, notch 3330 may provide clearance for rear hinge 641 to deployrear wing 640 as shown and described in FIG. 6. Thus, the shape andposition of notch 3330 may be dependent on the shape rear hinge 641. Inanother example, the shape and location of notch 3330 may be configuredto support rear wing 640. In yet another example, body 3310, ring 3320,notch 3330, and angled edge 3340 may form a continuous tubularstructure. The material used to form support tube 3300 may be Teflontubing. In other examples, the above-described elements may beimplemented differently and are not limited to the examples shown anddescribed.

FIG. 34 illustrates an exemplary incision seal. Here, incision seal 3400may include base 3410, recess 3420, first housing opening 3430, secondhousing opening 3440, and groove 3450. In some examples, base 3410,recess 3420, first housing opening 3430, and second housing opening 3440may be implemented similarly or substantially similar in function andstructure to like-named elements as shown and described in FIG. 8 andFIG. 9. As shown here, first housing opening 3430 may be disposed on anouter surface of incision seal 3400 and be configured to provide a lumenfor objects inserted into first housing opening 3430 to reach secondhousing opening 3440, or vice versa. Second housing opening 3430 may bedisposed on recess 3420 which is located along the length of base 3410.In some examples, first housing opening 3430 and second housing opening3440 may be of different shapes or sizes. The different sizes mayprovide different functionality to the two ends of the lumen. Forexample, first housing opening 3430 may be configured to support thecoupling of a connector and a graft vessel. In another example, secondhousing opening 3440 may be configured to support the coupling of theconnector and a main vessel. As shown here, second housing opening 3440may be triangular in shape and have rounded corners to accommodate thedeployed wings or barbs of the connector (as shown and describe in FIGS.2-7), thereby allowing the incision seal to seat securely on a wall ofthe main vessel when the wings or barbs of the connector are deployed.

Incision seal 3400 may further include groove 3450. Groove 3450 may bedisposed within a lumen connecting first housing opening 3430 and secondhousing opening 3440. As an example, groove 3450 may be configured tocontact a support tube inserted into second housing opening 3440. Insome examples, the support tube may be implemented similarly orsubstantially similar in function and structure to support tube 3300 asshown and described in FIG. 33. When ring 3320 of support tube 3300 andgroove 3450 are in contact, movements of incision seal 3400 may alsoaffect support tube 3300. For example, support tube 3300 and incisionseal 3400 may move in unison once contact has occurred. As an example,groove 3450 may be a recessed ring located within the lumen. Therecessed ring may have a larger diameter than the diameter of the lumen.This may prevent support tube 3300 from passing entirely through thelumen between first housing opening 3430 and second housing opening3440. In another example, groove 3450 may be protrusion located withinthe lumen. In yet other examples, groove 3450 may be any one or moreshapes located within the lumen that prevents ring 3320 disposed on abody of the support tube from passing through.

Incision seal 3400 may comprise a medical grade material. In someexamples, the medical grade material may be transparent. This may allowa surgeon to view the graft vessel and the main vessel when the twovessels are coupled to one another. This may also help the surgeonlocate the source of any leakages creates from the coupling of the graftvessel and the main vessel. In other examples, the medical gradematerial may be malleable and capable of receiving and securely lodgingan object within incision seal 3400. This may allow incision seal 3400to securely engage with a connector without the use of slots or guides.In some examples, the connector may be implemented similarly orsubstantially similar in function and structure to the connector asshown and described in FIGS. 2-7. For example, barb 620 of FIG. 6belonging to a connector 600 of FIG. 6 inserted inside a main vessel maypierce through a wall of the main vessel and enter incision seal 3400 atan entry point. Once the barb 620 enters the malleable material ofincision seal 3400, barb 620 may be lodged within the malleablematerial, thus preventing removal of barb 620 from incision seal 3400.Depending upon the shape of barb 620, piercing the wall of the mainvessel may create an opening in the wall that is of larger size than abase of barb 620. In some situations, the opening may result in leakageof fluids from inside the main vessel.

In some examples, the medial grade material may be configured tominimize the entry point of the fastener into incision seal 3400. Thismay allow incision seal 3400 to maintain a substantially smooth surfaceafter barb 620 has entered incision seal 3400. As an example, the entrypoint may expand when presented with wider portions of the fastener andcontract when presented with narrower portions of barb 620. This mayresult in the malleable material forming a seal around barb 620,regardless of the size or shape of the barb. Thus, when incision seal3400 is seated on the wall of the main vessel, the substantially smoothsurface of incision seal 3400 may cover any openings in the wall of themain vessel created from the fastener piercing the wall. This mayminimize the leakage from any openings in the wall of the main vessel.

As an example, incision seal 3400 may comprise of a silicone basedmaterial. Barb 620 may pierce recess 3420 and become lodged (i.e.secured) within the silicone based material. As barb 620 enters incisionseal 3400, the silicone based material may conform to the shape of barb620, thus forming a tight seal between recess 3420 and the barb. Thetight seal may provide a substantially smooth and uniform surface alongrecess 3420. This may allow recess 3420 to uniformly cover the wall ofthe main vessel, thus minimizing any leakage coming from the mainvessel. As shown here, incision seal 3400 may be formed from amonolithic piece of material. In other examples, the above-describedelements may be implemented differently and are not limited to theexamples shown and described.

FIG. 35 illustrates a process flow diagram of an exemplary method forperforming sutureless vascular anastomosis. Method 3500 may couple agraft vessel to an incision in a main vessel using a connector, anincision seal, and a support tube. In some examples, the connector,incision seal, and support tube may be implemented similarly orsubstantially similar in function and structure as like-named elementsshown and described in FIG. 32 (e.g., graft vessel 3210, incision seal3230, support tube 3250, connector 3240, main vessel 3220, and incision3290), which is referenced for purpose of providing examples andlike-named elements and varying descriptions may be found herein.

Here, method 3500 begins by cutting graft vessel 3210 at step 3502.Graft vessel 3210 may be interchangeably referred to as a “firstvessel,” a “donor artery,” or “other vessel.” As an example, graftvessel 3210 may be clamped at two points to stop the blood flow in asection of graft vessel 3210. This may help minimize blood loss fromgraft vessel 3210 during the vascular anastomosis procedure. As anotherexample, graft vessel 3210 may be cut at an angle. The angle may bedetermined by the junction between graft vessel 3210 and the wall ofmain vessel 3220 and implemented at varying degrees (e.g., 15, 25, 35,45, 90 degrees, or others). This may minimize leakage from the junctionbetween graft vessel 3210 and main vessel 3220 by allowing graft vessel3210 to securely contact the wall of main vessel 3220 at the junction.In other examples, the angle may be substantially the same as the angledetermined by the plane of the end of support tube 3250 relative to theaxis of the lumen or by the angle created by the junction of the lumenand the base of the incision seal. For example, the angle may be 10, 12,27, 38, 45 or any other angular degree measurement.

After cutting graft vessel 3210, a cut end of graft vessel 3210 ispulled through incision seal 3230 at step 3504. In some examples,incision seal 3230 may be implemented similarly or substantially similarin function and structure as incision seal 3230 shown and described inFIG. 34. As an example, graft vessel 3210 may be pulled through a lumenof incision seal 3230 with the use of a precision grasping instrument.In some examples, the precision grasping instrument may be a pair ofpliers or tweezers.

After pulling graft vessel 3210 though incision seal 3230, graft vessel3210 is subsequently pulled through support tube 3250 at step 3506. Insome examples, support tube 3250 may be implemented similarly orsubstantially similar in function and structure as the support tubeshown and described in FIG. 33. Similar to step 3504, a graspinginstrument may be used to pull graft vessel 3210 though support tube3250.

After graft vessel 3210 is pulled through support tube 3250, the cut endof graft vessel 3210 is folded over support tube 3250 at step 3508.Graft vessel 3210 may be folded over the outer surface of support tube3250 in preparation of securing graft vessel 3210 to connector 3240. Forexample, folding graft vessel 3210 over the length of the outer surfaceof support tube 3250 may apportion a segment (i.e. portion) of graftvessel 3210 that may later be used to securely couple graft vessel 3210to connector 3240. In some examples, graft vessel 3210 may be orientedwith respect to support tube 3250 before folding. For example, an angledend of support tube 3250 may be aligned with the angle of the cut end ofgraft vessel 3210 before folding. Properly orienting graft vessel 3210and support tube 3250 in this manner may assist in ensuring that boththe end of graft vessel 3210 and the end of support tube 3250 securelycontact the wall of main vessel 3220 when graft vessel 3210 is coupledto main vessel 3220. This may minimize leakage at the junction of mainvessel 3220 and graft vessel 3210. In some examples, a French dilatormay used during the folding of graft vessel 3210. For example, theFrench dilator may be inserted into, graft vessel 3210 before graftvessel 3210 is folded over support tube 3250. This may provide a rigidsupport inside graft vessel 3210, thus simplifying manipulation of theposition and orientation of graft vessel 3210. As an example, the Frenchdilator may assist in aligning graft vessel 3210 and support tube 3250.In another example, the French dilator may assist in folding graftvessel 3210 over support tube 3250. The French dilator may be leftwithin graft vessel 3210 to maintain the configuration of graft vessel3210 and support tube 3250 until graft vessel 3210 is ready for use.

After graft vessel 3210 is folded over support tube 3250, incision 3290is created on the wall of main vessel 3220 at step 3510. Incision 3290may be created at a location where a surgeon wishes for graft vessel3210 to couple with main vessel 3220. In some examples, incision 3290may be created by piercing the wall of main vessel 3220 with a needle.The needle may comprise a hollow cylinder loaded with a guide wireconfigured to assist the insertion of connector 3240 into main vessel3220. As an example, the needle may pierce the wall of main vessel 3220at an angle that minimizes the likelihood of accidentally piercingthrough the opposite wall of main vessel 3220. The needle loaded withthe guide wire may be inserted into main vessel 3220 and then removedwhile leaving the guide wire inside main vessel 3220. For example, theneedle may pierce the wall of main vessel 3220, enter main vessel 3220with the guide wire, and retract from main vessel 3220 leaving the guidewire inside main vessel 3220. A portion of main vessel 3220 surroundingthe needle entry point may be clamped off prior to the incision. Thismay minimize the blood loss during the procedure.

After creating incision 3290 in main vessel 3220, an introducer isinserted into the incision at step 3512. The introducer may beconfigured to prepare the incision for insertion of connector 3240.After preparing the incision, a deployment tool may couple with theintroducer and deploy connector 3240 within main vessel 3220. In someexamples, the introducer may be threaded onto the guide wire and a tipof the introducer may be inserted into the incision. A dilator may becoupled to the tip of the introducer to ease the tip of the introducerinside main vessel 3220. Once the tip of the introducer is inside mainvessel 3220, the dilator and the guide wire may be removed from mainvessel 3220.

FIG. 36 illustrates an exemplary introducer. Introducer 3600 may beconfigured to be inserted into an incision in a wall of a main vesseland to guide a deployment tool inside the main vessel. In some,examples, the deployment tool may be implemented similarly orsubstantially similar in function and structure as the syringe shown anddescribed in FIG. 37 (discussed below). Here, introducer 3600 mayinclude body 3610, locking mechanism 3612, alignment mark 3614, andintroducer tip 3620. Body 3610 may comprise a hollow chamber having awide opening and a narrow opening opposite of the wide opening. Body3610 may be configured to receive a deployment tool through the wideopening. A portion of the deployment tool may be housed within thehollow chamber so that the two components are securely coupled together.In some examples, the hollow chamber may be of sufficient length suchthat when the portion of the deployment tool is received, the deploymenttool and introducer 3600 are securely coupled. The narrow opening ofbody 3610 may be coupled to introducer tip 3620. Introducer tip 3620 maybe a cylindrical tube configured to guide a deployment tool through anincision along the wall of main vessel 3680. In some examples, an end ofthe deployment tool may be located inside main vessel 3680 when thedeployment tool is inserted into body 3610.

Body 3610 may be further coupled to locking mechanism 3612. Lockingmechanism 3612 may be disposed along the wide opening of body 3610. Insome examples, locking mechanism 3612 may be configured to interlockwith the deployment tool. Once interlocked, the deployment tool andintroducer 3600 may be securely coupled to one another. Thus, moving thedeployment tool may also move introducer 3600, and vice versa. As anexample, locking mechanism 3612 may be a male fitting or a femalefitting of a male-female interconnect pair. The counterpart of themale-female interconnect pair may be disposed on the deployment tool.Thus, the deployment tool may be interlocked with the introducer bypressing together the male fitting and the female fitting and screwingtogether the male-female interconnect pair. In some examples, the malefitting and the female fitting may be tapered to minimize leakage offluids traveling through the fittings. As shown here, locking mechanism3612 may be a male luer lock fitting.

To ensure that introducer 3600 is properly connected to the deploymenttool, body 3610 may also include alignment mark 3614. Alignment mark3614 may be configured to align with another alignment mark located onthe deployment tool. As an example, alignment mark 3614 may align withalignment mark 3715 of deployment tool 3700 shown in FIG. 37 when themale fitting and female fitting are properly aligned to be screwedtogether. This may provide a visual aid that introducer 3600 and thedeployment tool are ready to be connected. As another example, alignmentmark 3614 may align with alignment mark 3715 when the male fitting issecurely connected with the female fitting. This may provide visualconfirmation that the deployment tool and the introducer are properlyconnected. In other examples, introducer 3600 may be made of medicalgrade plastic materials, including Polyether ether ketone (PEEK). Inother examples, the above-described elements may be implementeddifferently and are not limited to the examples shown and described.

Returning back to FIG. 35, a deployment tool is coupled to theintroducer after the introducer is inserted into the incision at step3514. The deployment tool may be a syringe or other device configured todeploy connector 3240. In some examples, the deployment tool may includea fitting configured to join with another fitting disposed on theintroducer. When joined, the deployment tool and the introducer may besecurely connected to one another. As an example, a tip of thedeployment tool may be inserted into main vessel 3220 through a tip ofthe introducer when the deployment tool and the introducer are securelyconnected. In some examples, alignment marks are placed on both theintroducer and the deployment tool to ensure that the two tools areproperly connected.

FIG. 37 illustrates an exemplary syringe preloaded with a connector.Syringe 3700 may be configured to couple with an introducer and todeploy a connector inside a main vessel. In some examples, theintroducer may be implemented similarly or substantially similar infunction and structure as the introducer shown and described in FIG. 36.Here, syringe 3700 may include body 3710, handle 3711, plunger 3712, rod3714, locking mechanism 3716, deployment tip 3718, and connector 3720.Syringe 3700 may be configured to deploy connector 3720 from deploymenttip 3718 when plunger 3712 is depressed. As shown here, connector 3720may be pre-loaded within deployment tip 3718 to save valuable timeduring surgery. In other examples, syringe 3700 may be reusable byloading connector 3720 within deployment tip 3718 prior to surgery.

Body 3710 may comprise of a hollow chamber with handle 3711 disposedtowards one end. As an example, the hollow chamber may be configured tohouse plunger 3712. Plunger 3712 may be received through one end of body3710. In some examples, plunger 3712 may include a safety pin (notshown) configured to prevent accidental deployment of connector 3720.For example, the safety pin may intersect plunger 3712 and contact anedge of handle 3711 when syringe 3700 is not ready for use. Thisconfiguration may prevent plunger 3712 from being depressed. The safetypin may be removed from plunger 3712 when syringe 3700 is ready for use.In some examples, body 3710 may comprise plastic, glass, or othersynthetic or natural materials.

Plunger 3712 may be coupled to rod 3714. As shown here, rod 3714 mayinclude an end configured to couple with plunger 3712 and an oppositeend configured to deploy connector 3720. As an example, rod 3714 maypush connector 3720 through deployment tip 3718 when plunger 3712 isdepressed. Depressing plunger 3712 may push rod 3714 towards an end ofdeployment tip 3718 which in turn may push connector 3720 out of the endof deployment tip 3718. Thus, the rate of deployment of connector 3720may depend upon the rate that plunger 3712 is depressed. As an example,one end of rod 3714 may be approximately the same shape as an end ofplunger 2712. In another example, another end of rod 3714 may beapproximately the same diameter as deployment tip 3718.

As shown here, body 3710 may be coupled to locking mechanism 3716.Locking mechanism 3716 may be configured to connect or interlock with anintroducer. In some examples, the introducer may be implementedsimilarly or substantially similar in function and structure as theintroducer shown and described in FIG. 36. As an example, lockingmechanism 3716 may be a male fitting or a female fitting of amale-female interconnect pair. The counterpart of the male-femaleinterconnect pair may be disposed on introducer 3600. This may allowintroducer 3600 and syringe 3700 to securely interlock with one anotherwhen the male-female interconnect pair is threaded together. As shownhere, locking mechanism 3716 may be a female luer lock fitting. As anexample, connector 3720 may be located inside a main vessel when theintroducer and syringe 3700 are securely coupled. In some examples, themale-female interconnect pair may be tapered to minimize leakage.

In some examples, locking mechanism 3716 may include an alignment mark3715. Alignment mark 3715 may be configured to ensure that syringe 3700is properly connected with introducer 3600 before connector 3720 isdeployed. In some examples, a surgeon may infer information whenalignment mark 3715 is aligned with alignment mark 3614 of introducer3600. As an example, alignment of the alignment marks may confirm thatthe male-female interconnect pair are properly aligned to be screwedtogether. In another example, alignment of the alignment marks mayconfirm that the male-female interconnect pair are securely connected toone another and therefore, connector 3720 may be deployed by depressingplunger 3712. In yet other examples, the above-described elements may beimplemented differently and are not limited to the examples shown anddescribed.

Returning to FIG. 35, connector 3240 is deployed inside main vessel 3220at step 3516. As an example, a plunger belonging to a deployment tool(as shown in FIG. 37) may be depressed to deploy connector 3240. In someexamples, position of the deployment tool and the introducer may bemanipulated prior to deployment to ensure that connector 3240 isdeployed at the desired position inside main vessel 3220. For example,the introducer may be pulled out of the incision while leaving a tip ofthe deployment tool inside main vessel 3220. This may position thedeployment of connector 3240 in the center of main vessel 3220 or anyother desirable position for proper deployment of the wings and barbsbelonging to connector 3240 inside main vessel 3220.

After connector 3240 is deployed inside main vessel 3220, the introducer(as shown in FIG. 36) and the deployment tool (as shown in FIG. 37) areremoved from the incision at step 3518. In some examples, removing thedeployment tool may deploy a portion of connector 3240 outside mainvessel 3220. As an example, the portion of connector 3240 outside mainvessel 3220 may include a suture thread. The suture thread may be usedto seat connector 3240 along the wall of main vessel 3220.

After removing the introducer and the deployment tool, the wall of mainvessel 3220 is pierced with a barb of connector 3240 at step 3520.Piercing the wall of main vessel 3220 with the barb may allow the barbto become accessible to incision seal 3230 located outside main vessel3220. In some examples, piercing the wall of main vessel 3220 with thebarb may include a two step process. In a first step, connector 3240 maybe pulled by a suture thread attached to connector 3240. This mayposition the barb along the interior wall of main vessel 3220 andsimplify the locating of the barb from the exterior wall of main vessel3220. In a second step, a puncturing tool may be placed over thelocation of the barb to assist the barb through the wall of main vessel3220. As an example, the puncturing tool may be a tube that is pressedfirmly over the location of the barb while connector 3240 is pulled bythe suture thread. These opposing forces may cause the barb to piercethrough the wall of main vessel 3220. If there are multiple barbs, thepuncturing tool may be used multiple times to pierce each barb throughthe wall of main vessel 3220.

After the barb of connector 3240 has pierced the wall of main vessel3220, graft vessel 3210 is securely coupled to connector 3240 at step3522. This may include orienting an edge of graft vessel 3210 to mainvessel 3220 and securely coupling graft vessel 3210 to connector 3240.As an example, a dilator may have been used to maintain theconfiguration of graft vessel 3210 and support tube 3250 while mainvessel 3220 was being operated on. If a dilator was used, the dilatormay be removed before graft vessel 3210 is placed on top of connector3240. In some examples, graft vessel 3210 may be placed on an end ofconnector 3240 and the portion of graft vessel 3210 folded over supporttube 3250 may be unrolled over connector 3240. Advantages of unrollinggraft vessel 3210 over connector 3240 instead of pulling graft vessel3210 over connector 3240 may include minimizing traumatization to theinterior wall of graft vessel 3210. A handling tool may be used tounroll graft vessel 3210 from support tube 3250 onto connector 3240.Examples of handling tools may include pliers, tweezers, or otherprecision grasping tools. In some examples, the length of support tube3250 may be proportionate to the length of the portion of graft vesselused to securely couple with connector 3240. Once graft vessel 3210 isunrolled over connector 3240, support tube 3250 may slide down towardsthe junction between graft vessel 3210 and main vessel 3220. As anexample, a piece of graft vessel 3210 may be sandwiched between supporttube 3250 and main vessel 3220. This may provide a seal between the twovessels, thereby minimizing leakage at the junction. In another example,support tube 3250 may overlap the portion of connector 3240 contactinggraft vessel 3210. The overlap of support tube 3250 and connector 3240may sandwich the end of graft vessel 3210 in between support tube 3250and connector 3240. This may provide a restraining force to securelycouple graft vessel 3210 to connector 3240.

Once the graft vessel is attached to connector 3240, incision seal 3230is securely coupled to connector 3240 at step 3524. In some examples,incision seal 3230 may be slid down over support tube 3250 and securelycouple with one or more barbs of connector 3240 that are protruding fromthe wall of the main vessel (i.e. protruding barbs). For example,incision seal 3230 may receive the protruding barbs and secure theprotruding barbs inside incision seal 3230. As an example, theprotruding barbs may pierce through the surface of incision seal 3230and become lodged within incision seal 3230. Once lodged, incision seal3230 and connector 3240 may provide a clamping force that couples thegraft vessel to main vessel 3220. The clamping force may also apply aconstant downward pressure on support tube 3250. The downward pressuremay minimize leakage from the junction by allowing support tube 3250 tofirmly press the graft vessel on the wall of main vessel 3220. Thedownward force may also minimize the movement of the support tube afterthe procedure is complete.

After incision seal 3230 is securely coupled to connector 3240, thesuture thread coupled to connector 3240 is removed at step 3526. As anexample, the suture thread may be cut and removed. After removal of thesuture thread, the clamps may be removed from the graft vessel and mainvessel 3220, thereby returning blood flow.

As set forth above, measurements, dimensions, or other specificationsmay be varied and are not limited to those previously described.Variations in sizes, shapes, and processes may also be implemented andthe above-described examples are also not intended to be limiting.

The foregoing examples have been described in some detail for purposesof clarity of understanding, but are not limited to the detailsprovided. There are many alternative ways and techniques forimplementation. The disclosed examples are illustrative and notrestrictive.

What is claimed:
 1. An incision seal for coupling an anastomosisconnector with a main vessel and a graft vessel, the incision sealcomprising: a base having opposing sides and a concave recess configuredto partially cover the main vessel; a housing opening that intersectswith the concave recess of the base, wherein the housing openingcomprises a hollow cylindrical structure with an inner diameterconfigured to receive a graft vessel; a radius ring disposed around acircumference of an entrance of the housing opening and comprising atapered surface from an outer edge with an outer diameter that is largerthan the inner diameter of the housing opening to an inner edge locatedat the inner diameter of the housing opening, wherein the radius ring isconfigured to facilitate insertion of the graft vessel into the housingopening; a groove extending along an inner surface of a first side ofthe opposing sides of the base and configured to receive the anastomosisconnector; a first guide channel disposed along a first edge of thegroove; a second guide channel disposed along a second edge of thegroove and parallel to the first guide channel; a first slot disposed onthe first side of the base on the first guide channel; a second slotdisposed on the first side of the base on the second guide channel andoriented in a different direction than the first slot; a third slotdisposed on a second side of the opposing sides of the base; and atleast a fourth slot disposed on the second side of the base and orientedin a different direction than the third slot, wherein the first, second,third and fourth slots are configured to lock with first, second, thirdand fourth barbs, respectively, on the anastomosis connector, andwherein each of the first, second, third and fourth slots comprises: anaperture in the base that forms a latching port configured to receive arespective one of the first, second, third and fourth barbs; and a latchpocket disposed adjacent to the latching port and configured to engageand lock with the respective one of the first, second, third and fourthbarbs to prevent the locked barb from retracting back through thelatching port by the latch pocket, wherein each of the guide channels isconfigured to guide one of the first, second, third and fourth barbs ofthe anastomosis connector along the groove and into one of the slots,and wherein the incision seal and the anastomosis connector areconfigured to form a seal between the graft vessel and the main vesselwhen the latch pockets of the slots have locked with the barbs of theanastomosis connector.
 2. The incision seal of claim 1, wherein thebase, the housing opening, and the first, second, third and fourth slotsare monolithically formed as part of the incision seal.
 3. The incisionseal of claim 1, wherein the incision seal is formed using amedical-grade material.
 4. The incision seal of claim 3, wherein themedical-grade material is malleable.
 5. The incision seal of claim 1,wherein the incision seal is formed using an alloy.
 6. The incision sealof claim 1, wherein the incision seal is formed using an alloycomprising at least nickel and titanium.
 7. The incision seal of claim1, further comprising the anastomosis connector, wherein the incisionseal and the connector are formed of Nitinol.
 8. The incision seal ofclaim 7, further comprising an incision seal setting device forconnecting the incision seal to the anastomosis connector via the first,second, third and fourth barbs and the first, second, third and fourthslots.
 9. The incision seal of claim 8, wherein the incision seal andthe anastomosis connector are configured to sandwich the mainvessel-between them when the incision seal is connected to theanastomosis device using the incision seal setting device.
 10. Theincision seal of claim 1, further comprising-an upper lumen configuredto guide the graft vessel toward the housing opening.
 11. The incisionseal of claim 1, wherein the first, second, third and fourth barbs areconfigured to at least partially pierce the base to secure the incisionseal to the anastomosis connector using a puncturing tool.